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NOTICE OF RESTRICTIONOF USE <br />Underthce authority of Administrative Order No. 58- 03 -24 -F and Park and Open Space Rule R- 1:005(3), you art, hereby <br />notiliedrAltat 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 _ _ of the Park <br />and Open Space Rules, and/or Section ofthe Eugene Code, 1971, and /or ORS To wit you: <br />.mow- . _.. t. <br />(Dcscnption of the violation.) . <br />This restriction o�( use is effective h eginning on } ,'afd shall remain in effect until <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 SpaceRule 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 8c Open Space Division Director ( "the Division Director") <br />within 48 hours (exclusive ofweekends) 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 attr- ,, late and time shown above by: <br />(Signature of person issuing /delivering notice) <br />e <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />hitg Copy: Public Works - -Green Copy. File Yellow Copy: Report Copy _ Copy: Recipient <br />(Signature of person being issued the notice) <br />i <br />I <br />r <br />;r <br />i <br />S <br />i <br />Gold Copy: Officer Appeal notice Rev 0 <br />Name: Last - First - Middle <br />DOB:.: <br />Race /Sec: <br />Res. Address:. City <br />Stafe <br />Zip <br />Res. Phone: <br />Work Phone: <br />Underthce authority of Administrative Order No. 58- 03 -24 -F and Park and Open Space Rule R- 1:005(3), you art, hereby <br />notiliedrAltat 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 _ _ of the Park <br />and Open Space Rules, and/or Section ofthe Eugene Code, 1971, and /or ORS To wit you: <br />.mow- . _.. t. <br />(Dcscnption of the violation.) . <br />This restriction o�( use is effective h eginning on } ,'afd shall remain in effect until <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 SpaceRule 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 8c Open Space Division Director ( "the Division Director") <br />within 48 hours (exclusive ofweekends) 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 attr- ,, late and time shown above by: <br />(Signature of person issuing /delivering notice) <br />e <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />hitg Copy: Public Works - -Green Copy. File Yellow Copy: Report Copy _ Copy: Recipient <br />(Signature of person being issued the notice) <br />i <br />I <br />r <br />;r <br />i <br />S <br />i <br />Gold Copy: Officer Appeal notice Rev 0 <br />