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NOTICE F RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: <br />TIME: r �'L' <br />CASE M <br />n-VII <br />C I —n g <br />LOCATION (PARK/OPEN SPACE): i W tow 14 W—WA <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 />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />❑ <br />The basis for this Notice of Restriction of Use is that on you violated Section J 2, a1 of the Park <br />and Open Space Rules, and/or Section . "t �� — of the Eugene Code, 1971, and/or ORS �` �'{� Y . To wit, you: <br />PORVMD cE& A0 7- N AIIZ*A VII, 16� AF SGT <br />(Description of the violation.) <br />This restriction of use is effective beginning on 6 �gl �� 1 , and shall remain in effect until 06S a b �' <br />i <br />t, <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 />9s%l <br />(Signs of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(3'rgn 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. 04103 <br />H <br />Name: Last First Ml le <br />bvac�► IJ�r� �� <br />DOB <br />641 01/191 - L <br />Rac IS <br />01 <br />Res. Address City <br />ly o ` %00 L1J, 16 rJ�' <br />S <br />b <br />Zip <br />110 <br />Res. Phone: 7Z 1 <br />1 , <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 />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />❑ <br />The basis for this Notice of Restriction of Use is that on you violated Section J 2, a1 of the Park <br />and Open Space Rules, and/or Section . "t �� — of the Eugene Code, 1971, and/or ORS �` �'{� Y . To wit, you: <br />PORVMD cE& A0 7- N AIIZ*A VII, 16� AF SGT <br />(Description of the violation.) <br />This restriction of use is effective beginning on 6 �gl �� 1 , and shall remain in effect until 06S a b �' <br />i <br />t, <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 />9s%l <br />(Signs of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(3'rgn 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. 04103 <br />