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NOTICE OF RESTRICTION OF USE ���-- <br />and Notice of Right to Appeal Z-1 22 - 7 <br />DATE: ,,..- TIME: CASE #: <br />02 0a C�-, <br />LOCATION (PARK/OPEN SPACE): �4 <br />...... ...... LOW <br />Under the authority of Administrative order No. 55- 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 />*111 <br />/& Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />1 <br />The basis for this Notice of Restriction of Use is that on you violated Section Or'� 1 Of thdark <br />and Open Spac les, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />46j <br />(Description of the violation.) <br />This restriction of use is effective beginning on ��2����, and shall remain in effect until e:, <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 t to and time shown above by: <br />!7 <br />(Signature o erson issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />e Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04103 <br />Name: Last First A <br />DO ; <br />Racel <br />w <br />U <br />Res Address City <br />State <br />Zip <br />ltps. Phone: <br />Work Phone: <br />Under the authority of Administrative order No. 55- 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 />*111 <br />/& Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />1 <br />The basis for this Notice of Restriction of Use is that on you violated Section Or'� 1 Of thdark <br />and Open Spac les, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />46j <br />(Description of the violation.) <br />This restriction of use is effective beginning on ��2����, and shall remain in effect until e:, <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 t to and time shown above by: <br />!7 <br />(Signature o erson issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />e Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04103 <br />