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Under the authority of 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 />T Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on F, <br />violated Section _�O' ofthePark <br />and Open Space Rules, and/or Section <br />of the Eugene Code, 1971, and/or ORS To wit, you. <br />< <br />(Description of the violation.) 7r� <br />This restriction of use is effective beginning on t 01- P <br />and shall remain in effect until — - <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />informal hearing inust be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />w 'h' 48 h xclusive of weekends) of receint of th is N ot' ce at the follow in a address: 1820 Roosevelt. Blvd.. Euven e OR <br />it In ours (c <br />M <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which sball be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <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 inforrn at hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Fxclusion was delivered to the person named at the top of this Notice at the date and time shown above by. <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 />Whitt C opy: PuNic Works Green Copy File Ye I I ow Copy P upo ri Copy Pink Copy: Recipient Go] d C opv! O fficer Appeal notice Rov- (AM3 <br />Narnet Last I kl=iddle <br />DOB <br />LAQ`C0(,C J <br />0 <br />F <br />- <br />Res. Address� City <br />State <br />Zip <br />Z <br />Res. Pone: <br />Work Phme� <br />/SyN r5li ) ....... . ... <br />Under the authority of 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 />T Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />The basis for this Notice of Restriction of Use is that on F, <br />violated Section _�O' ofthePark <br />and Open Space Rules, and/or Section <br />of the Eugene Code, 1971, and/or ORS To wit, you. <br />< <br />(Description of the violation.) 7r� <br />This restriction of use is effective beginning on t 01- P <br />and shall remain in effect until — - <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />informal hearing inust be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />w 'h' 48 h xclusive of weekends) of receint of th is N ot' ce at the follow in a address: 1820 Roosevelt. Blvd.. Euven e OR <br />it In ours (c <br />M <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which sball be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <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 inforrn at hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Fxclusion was delivered to the person named at the top of this Notice at the date and time shown above by. <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 />Whitt C opy: PuNic Works Green Copy File Ye I I ow Copy P upo ri Copy Pink Copy: Recipient Go] d C opv! O fficer Appeal notice Rov- (AM3 <br />