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NOTICE OFREs OF USE <br />and Notice of Right to Appeal <br />DATE, <br />TIME: CASE 4 <br />0/ -�� <br />LOCATION (PARKJOPEN SPACE): <br />Under the authority of. d inistrative 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 />L;;K Entering in or using all City of Eugene parks, open spaces or facilitie.L <br />X <br />The basis for this Notice of Restriction of Use is that on. <br />you violated Section /0 of the Park <br />and Open Space Rules, and/or Section Z, of the Eugene Code, 11371, an&lor ORS To wit, you, <br />AIL-h <br />(Description of the violation.) <br />This restriction of use is effective beginning on , and shall remain in effect until 10—C <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 />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an infornial hearing to contest this Notice. A request for an <br />inforinal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 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 ird'ormal 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 info a I bearing the Division Director wi 11 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 informal hearing. <br />'rhi% 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and three indicated above. <br />(Signature of person being issued the notice) <br />Whac Copy: Public Works Gcn Copy File Yellow capy� Rernirl cony Pink Copy: kccipicm Gold Capy� Officer Appeal notice Rev U10 <br />Name: Last First Middle <br />DOB: <br />ace;;So"�: <br />A <br />Res. Address: city <br />State <br />Zip <br />Res, Phone: <br />Work Phone: <br />Under the authority of. d inistrative 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 />L;;K Entering in or using all City of Eugene parks, open spaces or facilitie.L <br />X <br />The basis for this Notice of Restriction of Use is that on. <br />you violated Section /0 of the Park <br />and Open Space Rules, and/or Section Z, of the Eugene Code, 11371, an&lor ORS To wit, you, <br />AIL-h <br />(Description of the violation.) <br />This restriction of use is effective beginning on , and shall remain in effect until 10—C <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 />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an infornial hearing to contest this Notice. A request for an <br />inforinal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 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 ird'ormal 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 info a I bearing the Division Director wi 11 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 informal hearing. <br />'rhi% 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 />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and three indicated above. <br />(Signature of person being issued the notice) <br />Whac Copy: Public Works Gcn Copy File Yellow capy� Rernirl cony Pink Copy: kccipicm Gold Capy� Officer Appeal notice Rev U10 <br />