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NOTICE OFRESTRICTION OF USE c3A 5$$5\5 <br />and notice of Right to Appeal <br />DATE: 1L29z ",S TIME- 16 _ CASE 4: <br />LOCATION (PARK/OPEN SPACE.): VV W- <br />L.lnder the authority of Administrative Order No. 58-03-24-F and Park and Open Space Ruse 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 />The basis for this Notice of Restriction of Use is that on D 1) , you violated Section� U Iv of the Park <br />and Open Space. Rules, and/or Section I •' AV 7 of the Eugene Code, 1971, and/or ORS , To wit, you. <br />(Description of the violation.) <br />This restriction of use is effective beginning on d w , 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 matte 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 fiillowing 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 NoticeearrV7tate and pnic shown above by: <br />(Signature of perAn issuing delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated abov=e. <br />k,inature of person being issued the notice) <br />While Copy. Public Works Green Copy: File Ycllow Copy: Report Citpy Pink Copy: recipient Gold Copy: Officer Appeal notice Rev IWO <br />Na last First Middle <br />f CAR <br />DOW <br />�'� <br />ka�r;!��.: <br />1 <br />ar_dc1i-cs <br />s: Y � City <br />State <br />Zip <br />s.. I'hi,�: _ <br />Work I111n3le <br />� <br />L.lnder the authority of Administrative Order No. 58-03-24-F and Park and Open Space Ruse 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 />The basis for this Notice of Restriction of Use is that on D 1) , you violated Section� U Iv of the Park <br />and Open Space. Rules, and/or Section I •' AV 7 of the Eugene Code, 1971, and/or ORS , To wit, you. <br />(Description of the violation.) <br />This restriction of use is effective beginning on d w , 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 matte 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 fiillowing 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 NoticeearrV7tate and pnic shown above by: <br />(Signature of perAn issuing delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated abov=e. <br />k,inature of person being issued the notice) <br />While Copy. Public Works Green Copy: File Ycllow Copy: Report Citpy Pink Copy: recipient Gold Copy: Officer Appeal notice Rev IWO <br />