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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE: 0 S " � � "" (`� TIME: CASE
<br />LOCATION (PARK/OPEN SPACE):
<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 />10 - / �& A.. L� C', So , i � �\<,
<br />The basis for this Notice of Restriction of Use is that on # `� 1 , you violated Section 6H of the Park
<br />and open Space Rules, and/or Section of the Eugene Code, 1 971, and/or ORS To wit, you:
<br />R0, < L�5 t
<br />. ........ L_
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on ID — t ` Z "it, and shall remain in effect until - 2 , 1&,
<br />If you enter in or use any City of Eugene park, open space or facility during the effective pdriod 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 />............ .. .? A7r-RS6
<br />(Signature of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />fi
<br />Oignature aperson being is ued the notice)
<br />ite Copy: Public works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev, 04/03
<br />Name: Last First Noddle
<br />DOB:
<br />Race /Sex:
<br />-zs
<br />�
<br />Res. Address: City State Zip
<br />Res. Phone:
<br />Work Phone:
<br />J
<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 />10 - / �& A.. L� C', So , i � �\<,
<br />The basis for this Notice of Restriction of Use is that on # `� 1 , you violated Section 6H of the Park
<br />and open Space Rules, and/or Section of the Eugene Code, 1 971, and/or ORS To wit, you:
<br />R0, < L�5 t
<br />. ........ L_
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on ID — t ` Z "it, and shall remain in effect until - 2 , 1&,
<br />If you enter in or use any City of Eugene park, open space or facility during the effective pdriod 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 />............ .. .? A7r-RS6
<br />(Signature of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />fi
<br />Oignature aperson being is ued the notice)
<br />ite Copy: Public works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev, 04/03
<br />
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