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AiA6 �n � � g 3 <br />NOTICE OF RESTRI TION OF USE <br />and Notice of Right toAppeal <br />DATE: O$ TIME: 16 I CASE #: 1 <br />LOCATION (PARK/OPEN SPACE): WAftl&rbN 17owsoid r7 , 1 PAa <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 you violated Section 14 of the Park <br />and Open Space Rules, and/or Section q. (qQ of the Eugene Code, 1971, and/or ORS To wit, you: <br />&& 9256 Leg VP 10Z N 411 MAIJA ANA AS4!J MlM0,J ff Affd& Ott t/,a/►.teFNEV JIM ;�kf <br />(Description of the violation.) <br />This restriction of use is effective beginning on 5 28 ZO1 , and shall remain in effect until % f <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 shown above by: <br />(Signattife of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Sigr ftture of p n be is ued the n ' <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 <br />Middle <br />DOB: <br />Rac Sex: <br />Res. Address: <br />City <br />S <br />*0/1 <br />Res. Phone: <br />Work Phone: <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 />The basis for this Notice of Restriction of Use is that on you violated Section 14 of the Park <br />and Open Space Rules, and/or Section q. (qQ of the Eugene Code, 1971, and/or ORS To wit, you: <br />&& 9256 Leg VP 10Z N 411 MAIJA ANA AS4!J MlM0,J ff Affd& Ott t/,a/►.teFNEV JIM ;�kf <br />(Description of the violation.) <br />This restriction of use is effective beginning on 5 28 ZO1 , and shall remain in effect until % f <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 shown above by: <br />(Signattife of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Sigr ftture of p n be is ued the n ' <br />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />