NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 04? 0 I5— 'TIME.: I IIZ,4/" CASE #: <br />LOCATION (PARK/OPEN SPACE): C. *s <br />'S— Zlsr2ZS <br />e, -741� <br />5 --V j 5-0541 <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 />10 A The basis for this Notice of Restriction of Use is that on 0 7U 4 J� , you violated Section of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />QPA230r8l) 6A1AC>JL, V <br />(Description of the violation.) <br />This restriction of use is effective beginning on d , o , and shall remain in effect until Lid 1 <br />If you cuter 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 he 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 Noticb-ro-3eu ate and time shown above by: <br />(Signature ref crson issuingldelivcring notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />Cgnature o#' person b6n , issued the notice) <br />White Copy: Public Works Green Copyr File fellow Copy: Repon Copy Pink Copy: Recipient Gold Cupy: Officer Appeal notice Rev. (W03 <br />Name: Laso J � hjrs,Jy �� m�x►7� MjdcilcD[]B:' <br />r <br />i/3 <br />Racy Six: <br />1A) <br />� <br />L1 �l�■ <br />i� <br />/ o <br />Res, ��� � City <br />�7/ r�� ,* <br />State <br />Zip <br />Res. Pi c���ei: .�� <br />•��.* <br />Work ,T�h�cp�n�e <br />! "V <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 />10 A The basis for this Notice of Restriction of Use is that on 0 7U 4 J� , you violated Section of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />QPA230r8l) 6A1AC>JL, V <br />(Description of the violation.) <br />This restriction of use is effective beginning on d , o , and shall remain in effect until Lid 1 <br />If you cuter 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 he 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 Noticb-ro-3eu ate and time shown above by: <br />(Signature ref crson issuingldelivcring notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />Cgnature o#' person b6n , issued the notice) <br />White Copy: Public Works Green Copyr File fellow Copy: Repon Copy Pink Copy: Recipient Gold Cupy: Officer Appeal notice Rev. (W03 <br />