Under the authority of. dministrative 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 />[3( Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on q <br />you violated Section j <br />V q the Park <br />f— � <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS —. To wit, you:_ <br />m j's a i e j n <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 info al hearing to contest this Notice. A request for an <br />informal 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 info al hearing to be conducted, which shall be not more than <br />72 hours (exclusive o weekends) of receipt of the request for hearin At the In fornial hearing the Division Diructor w I I I on <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 info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top orthis 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 />Whitu Copy: Public Works Green Copy! File Yet I ow Copy . RcNft Copy Pink Copy! Recipient g eld Copy 0 fficer Appea I notice Rev 04,0t <br />Name: Last First Middle <br />DOB: <br />Racei X: <br />L <br />An A MIA 0 L�F rzyA-A-I <br />1 <br />91.4 73 <br />L <br />1 I�ZAI <br />Res, Address: city <br />State <br />Zip <br />Res- pllone <br />Work Phone: <br />Under the authority of. dministrative 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 />[3( Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on q <br />you violated Section j <br />V q the Park <br />f— � <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS —. To wit, you:_ <br />m j's a i e j n <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 info al hearing to contest this Notice. A request for an <br />informal 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 info al hearing to be conducted, which shall be not more than <br />72 hours (exclusive o weekends) of receipt of the request for hearin At the In fornial hearing the Division Diructor w I I I on <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 info al hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top orthis 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 />Whitu Copy: Public Works Green Copy! File Yet I ow Copy . RcNft Copy Pink Copy! Recipient g eld Copy 0 fficer Appea I notice Rev 04,0t <br />