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I '7 qo <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal ' i — Q 5 C 7 t <br />DATE: cy t r TIME: 13 CA 0 CASE #: — 11� n% <br />LOCATION (PARK/OPEN SPACE): <br />Under the aut or ity of Administrative Order No. 58- 03 -24 -F and Park and Open Space Rule R- 1.005(3), you are hereby <br />notified tha ou are prohibited from (check box): <br />/J 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 03 15' 1 you violated Section 1. n A))f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS '75' To wit, you: <br />Vlou) 20dy, t'Jt -%'� `IyA !J-� wa U1 M <br />(Description of the violation.) <br />This restriction of use is effective beginning on Q `7 % (' 1) and shall remain in effect until 1 ) <br />l f 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 shown above by: <br />S. I/EL `( <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 Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />Name: Last <br />I <br />First <br />Middle <br />DOB: <br />Race /Sex: <br />Res. Address: <br />ci <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />y <br />V'tY1.t� <br />C) <br />- <br />N <br />N I <br />Under the aut or ity of Administrative Order No. 58- 03 -24 -F and Park and Open Space Rule R- 1.005(3), you are hereby <br />notified tha ou are prohibited from (check box): <br />/J 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 03 15' 1 you violated Section 1. n A))f the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS '75' To wit, you: <br />Vlou) 20dy, t'Jt -%'� `IyA !J-� wa U1 M <br />(Description of the violation.) <br />This restriction of use is effective beginning on Q `7 % (' 1) and shall remain in effect until 1 ) <br />l f 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 shown above by: <br />S. I/EL `( <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 Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />