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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: T[ME: CASE #: T ! U <br />LOCATION (PARKIOPEN SPACE):FisT� <br />LS <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Mule 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 09z;� �_ , you violated Section 4❑ :�--6 of the Park <br />Open Space Rules, and/or Section 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 , and shall remain in effect until 1017/ l <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 tiled with the Paries & Open Space Division Director ("the Division Director") <br />within 49 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 pres in testimony, from the informal hearing. <br />'This Notice shall remain in effect pending any requested hearing. <br />This Notice of l.`xclusion was delivered to the person named at the top of this Noti at the date and time shown above by: <br />/ 3 <br />I hereby acknowledge receipt of the above Notice on the date and time in <br />tore ofperson issuingidelivering notice) <br />Signature of person being issued the notice) <br />Whitc Capy: Public Works Orccn Copy: File Yellow Copy Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice kcv, 04!01 <br />Dame- Law/ first Mii+:'dllrye�FS{�J�jd/( <br />��}(/�/}� <br />R ce. S : <br />r �t dry (+' <br />5AM <br />0: <br />L <br />-A <br />Res. Address: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone; <br />72- TAdT <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Mule 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 09z;� �_ , you violated Section 4❑ :�--6 of the Park <br />Open Space Rules, and/or Section 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 , and shall remain in effect until 1017/ l <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 tiled with the Paries & Open Space Division Director ("the Division Director") <br />within 49 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 pres in testimony, from the informal hearing. <br />'This Notice shall remain in effect pending any requested hearing. <br />This Notice of l.`xclusion was delivered to the person named at the top of this Noti at the date and time shown above by: <br />/ 3 <br />I hereby acknowledge receipt of the above Notice on the date and time in <br />tore ofperson issuingidelivering notice) <br />Signature of person being issued the notice) <br />Whitc Capy: Public Works Orccn Copy: File Yellow Copy Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice kcv, 04!01 <br />