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[ -1 - 7 gnl <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal + �3 V <br />DATE: V 147 , TIME: i7, a 1 CASE 0 <br />OCATION (PARK/OPEN SPACE): MC &10C ��, F�� � V�. FA <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 />The basis for this Notice of Restriction of Use is that on 67 07 &0i i , you violated Sectionl1 1� of 9 of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS PS; b To wit, you: <br />tag - , V (Of 7*0 —&L. PACM64 <br />(Description of the violation.) / <br />This restriction of use is effective beginning on d7 /0� 0 i� , and shall remain in effect until I 07(18 it <br />t <br />: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 No at the date and time shown above by: <br />(Signaidre of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />V MQ .iiKK G� <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 />First Middle <br />DOB <br />Rac Sex: <br />C i <br />Jbokzl w TAL6� <br />081,5 t g <br />w � <br />Res. Address: <br />City <br />State <br />Zip <br />I <br />Res. Phone: <br />Work Phone: <br />00i <br />A <br />L r�' <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 />The basis for this Notice of Restriction of Use is that on 67 07 &0i i , you violated Sectionl1 1� of 9 of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS PS; b To wit, you: <br />tag - , V (Of 7*0 —&L. PACM64 <br />(Description of the violation.) / <br />This restriction of use is effective beginning on d7 /0� 0 i� , and shall remain in effect until I 07(18 it <br />t <br />: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 No at the date and time shown above by: <br />(Signaidre of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />V MQ .iiKK G� <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 />