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NOTICE OF RESTRICTION OF USE <br />and. Notice of Right to Appeal <br />DATE: f, TIME:– CASE # <br />LOCATION (PARK/OPEN SPACE): <br />js---15-bq� <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 />The basis for this Notice of Restriction of Use is that on � �� � , you violated Section/0/6 of the Park <br />and Open Space. Rules, and/or Section—qLcU 1 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 1, , and shall remain in effect until Mqo Ll (A <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 placefor 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 infomial 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 %hall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this N ` at the date and time shown above by: <br />(Sig j Ie"ofi person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />P <br />•�- u �� {Signature of person r, issued the, n()ticc] <br />While Copyr Public Works Grcen Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Cupy. Officer Appeal notice Rev. 01.'03 <br />Ne: Last irst ddl <br />DOB: <br />Race./Sex• <br />A C7C• C _ t LI '71r,miI96 <br />a <br />Res. Address. City <br />State <br />'Lir <br />Res. Mane: <br />W01-1, Phone: <br />1 c; -fii ) <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 />The basis for this Notice of Restriction of Use is that on � �� � , you violated Section/0/6 of the Park <br />and Open Space. Rules, and/or Section—qLcU 1 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 1, , and shall remain in effect until Mqo Ll (A <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 placefor 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 infomial 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 %hall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this N ` at the date and time shown above by: <br />(Sig j Ie"ofi person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />P <br />•�- u �� {Signature of person r, issued the, n()ticc] <br />While Copyr Public Works Grcen Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Cupy. Officer Appeal notice Rev. 01.'03 <br />