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NOTICE OF RESTRICTION OF USE D lb X <br />and Notice of Might to Appeal <br />DATE: C3' ?. TIME:CASE <br />LOCATION (pARK/OPEN SPACE): ALU AAP!�_ 1AKK <br />Under the authority of Administrative Order No. 58-03-24-1' and Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />)K Entering in or using all City of Eugene parks, open spaces or facilities. <br />—I <br />The basis for this Notice of Restriction of lyse is that on I _, you violated Section14' ithe Park <br />and Open Space Rules, and/or Section _ of the Eugene Code, 1971, and/or ORS To wit, you:___T_ <br />(Description of the violation.) <br />yw� <br />This restriction of use is effective beginning on 07zo) `J , and shall remain in effect until _00§& ... <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 (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 informal 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 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 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 Notic at the da hown above by: <br />rnahlre of person i °uinl;/dcliveriII8 notice) <br />�j <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />R=-� <br />(itore of person, being issued the notice) <br />White Copy: Public Works Greed Copy: File Yellmv Copy- Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev_ N/03 <br />Na e` Last First Middle <br />DOB: <br />1 <br />Res. ress: City <br />t <br />Zip <br />ties. Phone: <br />Work Phone. <br />Under the authority of Administrative Order No. 58-03-24-1' and Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />)K Entering in or using all City of Eugene parks, open spaces or facilities. <br />—I <br />The basis for this Notice of Restriction of lyse is that on I _, you violated Section14' ithe Park <br />and Open Space Rules, and/or Section _ of the Eugene Code, 1971, and/or ORS To wit, you:___T_ <br />(Description of the violation.) <br />yw� <br />This restriction of use is effective beginning on 07zo) `J , and shall remain in effect until _00§& ... <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 (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 informal 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 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 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 Notic at the da hown above by: <br />rnahlre of person i °uinl;/dcliveriII8 notice) <br />�j <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />R=-� <br />(itore of person, being issued the notice) <br />White Copy: Public Works Greed Copy: File Yellmv Copy- Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev_ N/03 <br />