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i I'M "� <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />ATE: (� ( Z 7 ( V_ TIME: ( y S FS CASE #: Od �� <br />LOCATION (PARK/OPEN SPACE): PA-e M V' CAC S / SP-0 6 AA $ 1 - <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 />O L 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 C) [ 0 1 a , you violated Section of the Park <br />Q <br />and Open Space Rules, and/or Section t gal of the Eugene Code, 1971, and/or ORS 171 o bI it, you: r <br />C' A04ZrI O� i kASP l ss ;[ r 949 (c . NM bra S S t0Z of Mdg 4- W .'Prt-f-v,J <br />(Description of the violation.) 1 6 ! 6 A si!4 t- <br />-his restriction of use is effective beginning on 0 /a7 r e2 , and shall remain in effect until 0 I / l3 <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 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 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 'ce at the date and time shown above by: <br />4 3 9 5 <br />Si afore of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indt ed above. <br />1 <br />V <br />(Si pet on being issued tffe notice) <br />f <br />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />N e: Last_ Fl t Middle <br />DOB: <br />e/Sexi <br />©nli9'�- <br />a( 0 g q <br />0 1 r <br />v <br />Re Address: City <br />State I Zip <br />Res. Phone: <br />Work 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 />O L 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 C) [ 0 1 a , you violated Section of the Park <br />Q <br />and Open Space Rules, and/or Section t gal of the Eugene Code, 1971, and/or ORS 171 o bI it, you: r <br />C' A04ZrI O� i kASP l ss ;[ r 949 (c . NM bra S S t0Z of Mdg 4- W .'Prt-f-v,J <br />(Description of the violation.) 1 6 ! 6 A si!4 t- <br />-his restriction of use is effective beginning on 0 /a7 r e2 , and shall remain in effect until 0 I / l3 <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 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 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 'ce at the date and time shown above by: <br />4 3 9 5 <br />Si afore of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indt ed above. <br />1 <br />V <br />(Si pet on being issued tffe notice) <br />f <br />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />