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NOTICE "FRESTRICTION OF USE ����L `� 3,3
<br />and Notice of Right to Appeal �
<br />DATE: TIME: r � CASE #:
<br />LOCATION (PARK/OPEN SPACE ) : T
<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 />§1,,. Entering in or using all City of Eugene parks, open spaces or facilities.
<br />X
<br />The basis for this Notice of Restriction of Use is that on : L. •2 , you violated Section t- 0 d of the Park
<br />and open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:
<br />5X55
<br />(Description of the violation.)
<br />4,
<br />This restriction of use is effective beginning on d U l 3 ( 2, and shall remain in effect until 0 7�31 P.
<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) ofrece* t 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 a e date and time s�iown above by:
<br />(Signat
<br />pllk,of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicate
<br />.P rri, G,PjG p
<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. 04143
<br />Name: Last First iddle
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<br />DOB:
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<br />Res. Address: Ci
<br />State
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<br />Res. Phone:
<br />work hone:
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<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 />§1,,. Entering in or using all City of Eugene parks, open spaces or facilities.
<br />X
<br />The basis for this Notice of Restriction of Use is that on : L. •2 , you violated Section t- 0 d of the Park
<br />and open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you:
<br />5X55
<br />(Description of the violation.)
<br />4,
<br />This restriction of use is effective beginning on d U l 3 ( 2, and shall remain in effect until 0 7�31 P.
<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) ofrece* t 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 a e date and time s�iown above by:
<br />(Signat
<br />pllk,of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicate
<br />.P rri, G,PjG p
<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. 04143
<br />
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