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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: M�L'!r <br />TIME: <br />CASE #: <br />IS-- I <br />LOCATION (PARK/OPEN SPACE): <br />F,5•i fes/ <br />3toe-k5 M <br />OI'r(e--, <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 />XEntering 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 4 &�S 1!' , you violated Section 6 of the Park <br />and Open Space Rules, and/or Section tL �of the Eugene Code, 1971, and/or ORS , To wit, you: <br />G <br />(Description of the violation.) <br />This restriction of use is effective beginning on 02, -)S -/C , and shall remain in effect until <br />d99� / �— <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 entitles] 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 ofwcckends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />974.02. <br />The Division Director shall schedule a lime and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exelusive 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 N[7liL'e of Exclusion was delivered to the person named at the top of this No53vc- <br />(Signature <br />he date and time shown above by: <br />--- 3(Signfperson issuingldclivcring notice) <br />I hereby acknowledge receipt ofthe above Notice on the date and time indicated of person being issued the notice) <br />While. Copy: Public Works Gteen Copy: File. Yelkow Copy: Rcport Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rcv, 04/03 <br />Name: Las( First Middle <br />DC)Q <br />Racc;Sex: <br />9 <br />x <br />Res. Address: city <br />State <br />'Lip <br />Res. Phonc: <br />Work Phone: <br />k^-) <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 />XEntering 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 4 &�S 1!' , you violated Section 6 of the Park <br />and Open Space Rules, and/or Section tL �of the Eugene Code, 1971, and/or ORS , To wit, you: <br />G <br />(Description of the violation.) <br />This restriction of use is effective beginning on 02, -)S -/C , and shall remain in effect until <br />d99� / �— <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 entitles] 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 ofwcckends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />974.02. <br />The Division Director shall schedule a lime and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exelusive 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 N[7liL'e of Exclusion was delivered to the person named at the top of this No53vc- <br />(Signature <br />he date and time shown above by: <br />--- 3(Signfperson issuingldclivcring notice) <br />I hereby acknowledge receipt ofthe above Notice on the date and time indicated of person being issued the notice) <br />While. Copy: Public Works Gteen Copy: File. Yelkow Copy: Rcport Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rcv, 04/03 <br />