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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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />F1 <br />60 <br />The basis for this Notice of Restriction of Use is that on is , you violated Section 0 of the Park <br />of the Eugene Code, 1971, and/or ORS 'ro wit, you: <br />and Open Space Rules, and/or Section -�2, 9 19 <br />(Description of the violation.) <br />This restriction of arse is effective beginning on &1 and shall remain in effect until ' is <br />100 <br />I f 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 />Pursuant to Park and Open Space Rule -1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />inforaral hearing must be made in writing and filed with the Parks & Open Space Division Director (,"the Division Director") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the info al hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the infra al 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 teqtirnony, from the informal hoaring. <br />This Notice shall remain in effect pending any requested hearing. <br />This N otice o Exclusion was delivered to the person named at the top of this N otice at the date and time shown above by: <br />(S ignature of person i ss i iing 'de ( ived np <br />, 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 C Vy! Public Works Gwen Cbpy File Ye How Copy; Rep) rt Copy Pink Copv! Recipient Gold Copy Officer Appeal notice RL v- 64!03 <br />Narne: Last First Middle <br />1)013. <br />R ace .S <br />' ' G L 14 <br />R", Address: City <br />State <br />Zip <br />Res- Plwne: <br />Work Phones <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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />F1 <br />60 <br />The basis for this Notice of Restriction of Use is that on is , you violated Section 0 of the Park <br />of the Eugene Code, 1971, and/or ORS 'ro wit, you: <br />and Open Space Rules, and/or Section -�2, 9 19 <br />(Description of the violation.) <br />This restriction of arse is effective beginning on &1 and shall remain in effect until ' is <br />100 <br />I f 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 />Pursuant to Park and Open Space Rule -1.074 you are entitled to an informal hearing to contest this Notice. A request for an <br />inforaral hearing must be made in writing and filed with the Parks & Open Space Division Director (,"the Division Director") <br />within 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the info al hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the infra al 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 teqtirnony, from the informal hoaring. <br />This Notice shall remain in effect pending any requested hearing. <br />This N otice o Exclusion was delivered to the person named at the top of this N otice at the date and time shown above by: <br />(S ignature of person i ss i iing 'de ( ived np <br />, 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 C Vy! Public Works Gwen Cbpy File Ye How Copy; Rep) rt Copy Pink Copv! Recipient Gold Copy Officer Appeal notice RL v- 64!03 <br />