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NOTICE DIS RESTRICTION OF USE
<br />p, and Notice of Right to Appeal l
<br />DATE: I TIME: 26 G CASE #:
<br />LOCATION (PARK/OPEN SPACE): W 5 jV SLC
<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 />1 P0 Entering in or using all City of Eugene parks, open spaces or facilities.
<br />c,
<br />S c 1!,ofo q)
<br />The basis for this Notice of Restriction of Use is that on o �� } l , you violated Section of the Park
<br />and Open Space Rules, and/or Section of the Eugene Code, 1971, andJor ORS To wit, you:
<br />1&3 C, a,M (n -;,j -,y WT 5, ,AG� 2s�J wzy rfy f r
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on og o-) 15 , and shall remain in effect until ? (�0-1 l 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 he 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: 1 820 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 Notice at the elate and time shown above by:
<br />- J I �,Nz �)
<br />(Signature of person issutngVdelivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and tirnc indicated above.
<br />/0 -
<br />(Signature of person being issued the notice)
<br />White Cupy: Public Works Green Copy File Yellow Copy. Repon Copy Pink Copy Ru�Jpicnt Gold Copy: Officer Appeal notice Rev -16410z
<br />Name: Ust 1 r' First Middle
<br />DOB:
<br />RacclSex: _
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<br />5
<br />Res. A_&, City State
<br />Zip
<br />Res. Phone:
<br />Work Phone:
<br />j:
<br />I t_. ON
<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 />1 P0 Entering in or using all City of Eugene parks, open spaces or facilities.
<br />c,
<br />S c 1!,ofo q)
<br />The basis for this Notice of Restriction of Use is that on o �� } l , you violated Section of the Park
<br />and Open Space Rules, and/or Section of the Eugene Code, 1971, andJor ORS To wit, you:
<br />1&3 C, a,M (n -;,j -,y WT 5, ,AG� 2s�J wzy rfy f r
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on og o-) 15 , and shall remain in effect until ? (�0-1 l 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 he 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: 1 820 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 Notice at the elate and time shown above by:
<br />- J I �,Nz �)
<br />(Signature of person issutngVdelivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and tirnc indicated above.
<br />/0 -
<br />(Signature of person being issued the notice)
<br />White Cupy: Public Works Green Copy File Yellow Copy. Repon Copy Pink Copy Ru�Jpicnt Gold Copy: Officer Appeal notice Rev -16410z
<br />
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