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Under the authority or Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning o &�— and shall remain in effect until 04- IL <br />If you enter in or Use any City of Eugene park, open space or facility during the effective period of this Notice, you maybe <br />arrested and charged with criminal trespass in the second degree, <br />ppipipp11 111111111sr 1 <br />HIMMIM Hudling lllus� oe Inuue Eli wilting ME Mea wun Tne rarKs Y upell5pace 1117171511 D1177-ful k FAUP Mn RT r 7 Wor <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address. 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />livs) 0 1 feceipt. *1 L11C I cqucbt ILPI I [Cmilig. TR 111V 11110111MI HUM I Rje, LAC D1VTqTTTFFJTTUUFLff <br />consider testimony from you, City personnel involved in the incident that, resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person narned at the top of this Notice at the date and time shown above by <br />k^ <br />. .... ... ..... <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Grem Copy: File Yellow Copy: ReporT Copy Pink Copy: Recipient Gold Cop y! 0M cer Ap pea I notice Rev, OV03 <br />Nanip: Last FiNt Middle <br />DOBt <br />b6 <br />Race., <br />Res. 4ddres4: city TState <br />Zip <br />Res. Phone: <br />Work Phone'. <br />Under the authority or Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning o &�— and shall remain in effect until 04- IL <br />If you enter in or Use any City of Eugene park, open space or facility during the effective period of this Notice, you maybe <br />arrested and charged with criminal trespass in the second degree, <br />ppipipp11 111111111sr 1 <br />HIMMIM Hudling lllus� oe Inuue Eli wilting ME Mea wun Tne rarKs Y upell5pace 1117171511 D1177-ful k FAUP Mn RT r 7 Wor <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address. 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />livs) 0 1 feceipt. *1 L11C I cqucbt ILPI I [Cmilig. TR 111V 11110111MI HUM I Rje, LAC D1VTqTTTFFJTTUUFLff <br />consider testimony from you, City personnel involved in the incident that, resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person narned at the top of this Notice at the date and time shown above by <br />k^ <br />. .... ... ..... <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Grem Copy: File Yellow Copy: ReporT Copy Pink Copy: Recipient Gold Cop y! 0M cer Ap pea I notice Rev, OV03 <br />