New Search
I v5 V(,g I ..j— a r- -I— <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />-DATE: 7 Cm �� T1ME: CASE #: 2�1 17 1 <br />LOCATION (PARK/OPEN SPACE): �/ £sr��� ' (S up C <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 />FM <br />The basis for this Notice of Restriction of Use is that on 2 �G_ (/ you violated Section of the Park <br />and Open Space Rules, and/or Section f the Eugene Code, 1971, and/or ORS G YF wit, you: <br />pons J 1 ,100' 0FA- 5:'dA4001_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on l ( , and shall remain in effect until <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 Notice at the date and time show jj above by: <br />sir 1!_e? <br />(Signature ofperso .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 Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />Name: L t First Middle <br />- A I W a r"1AV-S <br />DOB: �j <br />0 <br />Race /Sex: <br />W /' yU <br />1 <br />a <br />Res. Address: 3 `Y City <br />3638 : , 4- 40M---- <br />State <br />Zip <br />z <br />es. Phone: <br />6. <br />Work Phonef <br />/ <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 />FM <br />The basis for this Notice of Restriction of Use is that on 2 �G_ (/ you violated Section of the Park <br />and Open Space Rules, and/or Section f the Eugene Code, 1971, and/or ORS G YF wit, you: <br />pons J 1 ,100' 0FA- 5:'dA4001_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on l ( , and shall remain in effect until <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 Notice at the date and time show jj above by: <br />sir 1!_e? <br />(Signature ofperso .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 Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />