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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: {`]�']]$ TIME: ()77 2, CASE #: <br />LOCATION (PARK/OPEN SPACE): FA6T ?AlA.�- 13(oc-4cS <br />S�C?� " v� <br />finder 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 />j& Entering in or using all City of Fugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on eN0 $1 -5— , you violated Section It Or b of the Park <br />and Open Space. Rules, and/or Section of the Eugene. Code, 1971, and/or ORS . To wit, you: <br />next, 5-'a 0►�Rl� to o� A2 (3 �t-e-r <br />(Description of the violation.') <br />This restriction of use is effective beginning on d ! C)315--, and shall remain in effect until 1 [9 o $?'r S— . <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 Fled 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 Noti • at the date and time shown above by: <br />35j— <br />(Signat re of person issuingldclivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and timee indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: Hic Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: C31Fiser Appeal notice Rev- 04103 <br />Name.: Last First Middle <br />D013: <br />Raece'Sex: <br />Also <br />5 7 7 <br />iga <br />Res- Address: City <br />Slate <br />Zip <br />Rcs. Phone: <br />Work Phone: <br />x <br />finder 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 />j& Entering in or using all City of Fugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on eN0 $1 -5— , you violated Section It Or b of the Park <br />and Open Space. Rules, and/or Section of the Eugene. Code, 1971, and/or ORS . To wit, you: <br />next, 5-'a 0►�Rl� to o� A2 (3 �t-e-r <br />(Description of the violation.') <br />This restriction of use is effective beginning on d ! C)315--, and shall remain in effect until 1 [9 o $?'r S— . <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 Fled 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 Noti • at the date and time shown above by: <br />35j— <br />(Signat re of person issuingldclivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and timee indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: Hic Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: C31Fiser Appeal notice Rev- 04103 <br />