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LOCATION (PARKJOPEN SPACE): <br />1 i--C1:5T elv-�c 4COW-s <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 />A <br />The basis for this Notice of Restriction of Use is that on you violated Section f the Park <br />and Open Space Rules, and/or Section —D of the Eugene Code, 1971, and/or ORS —. To wit, you: <br />1 <br />Cr,S5 *�Eo-cn &!qa )^A -t elYl k Ls <br />(Description of the violation.) <br />This restriction of use is effective beginning on <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 />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal 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 (OXCIUSiVc of weekends of receipt of this Not iceat the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <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 named at the top of this Notice at the date and time shown above by: <br />' <br />�+ <br />(Signature of person 2 L <br />issuing/d ivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />- - ---------- <br />(Signature of p frs�onbcing issued the notice) <br />White Copy; Nblic Warks Green Copy: File Yellow Copy! Rcpun Copy Pink Copy: Recipient (!old Copy: Offi cer A pp�W notice Ruv. W/03 <br />Name: Last Finq Middle <br />en: <br />1)013 <br />Race/Sex: <br />U <br />Res. Addri! City <br />State <br />I <br />Zip <br />I <br />Res- Phone: <br />Wo rl�—PI�1111c, <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 />A <br />The basis for this Notice of Restriction of Use is that on you violated Section f the Park <br />and Open Space Rules, and/or Section —D of the Eugene Code, 1971, and/or ORS —. To wit, you: <br />1 <br />Cr,S5 *�Eo-cn &!qa )^A -t elYl k Ls <br />(Description of the violation.) <br />This restriction of use is effective beginning on <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 />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal 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 (OXCIUSiVc of weekends of receipt of this Not iceat the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <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 named at the top of this Notice at the date and time shown above by: <br />' <br />�+ <br />(Signature of person 2 L <br />issuing/d ivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />- - ---------- <br />(Signature of p frs�onbcing issued the notice) <br />White Copy; Nblic Warks Green Copy: File Yellow Copy! Rcpun Copy Pink Copy: Recipient (!old Copy: Offi cer A pp�W notice Ruv. W/03 <br />