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NOTICE OF RESTRICTION O USE <br />anti Notice of Right to Appeal <br />DATE: 2 TIME: Iq 4o CASE #: IS, 45S73 ' <br />LOCATION (PARKIOPEN SPACE): W,4S}{SN -rcn/ <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 />K. Entering in or using all City of Eugene parks, open. space.% or facilities. <br />n <br />The basis for this Notice of Restriction of Use is that on S)q 101�� , you violated Section . CIO( 0of the Park <br />and Open Space Rules, and/or Section a► `L— of the Eugene. Code, 1971, and/or ORS . To wit, you: <br />f. <br />(Description of the violation.) <br />This restriction of use is effective beginning on _ , and shall remain in effect until 1 <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 />writhin48 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 Noticc, 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 date and time shown above by: <br />01. <br />(Signature. of person issuing/delivering notice) <br />I hereby acknowledge receipt of the. above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Grccn Copy: File Yellow Copy: Report Copy Pink Copy. Recipient Gold Copy; Officer Appeal notice Rev. 04!03 <br />Name: Last First Middle <br />DOB: <br />Race!Se <br />iH <br />6 <br />L <br />e "t <br />U <br />Res. Address: City <br />fs(atcl <br />Lip <br />Res. Phone: <br />- <br />Wort: Phone: <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 />K. Entering in or using all City of Eugene parks, open. space.% or facilities. <br />n <br />The basis for this Notice of Restriction of Use is that on S)q 101�� , you violated Section . CIO( 0of the Park <br />and Open Space Rules, and/or Section a► `L— of the Eugene. Code, 1971, and/or ORS . To wit, you: <br />f. <br />(Description of the violation.) <br />This restriction of use is effective beginning on _ , and shall remain in effect until 1 <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 />writhin48 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 Noticc, 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 date and time shown above by: <br />01. <br />(Signature. of person issuing/delivering notice) <br />I hereby acknowledge receipt of the. above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Grccn Copy: File Yellow Copy: Report Copy Pink Copy. Recipient Gold Copy; Officer Appeal notice Rev. 04!03 <br />