New Search
I g2-1 -' q jcl <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 0 9 0 4 1 ' 1 TIME: p CASE #: <br />LOCATION (PARK/OPEN SPACE): <br />U <br />H <br />a <br />Name: Last First Middle <br />DO <br />b 1,,, <br />Race /Sep: <br />T'--, <br />Res. Address: CitV <br />Sta <br />Zip <br />Res. Ph <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 />V , Entering in or using all City of Eugene parks, open spaces or facilities. <br />E <br />1, Lx)q <br />The basis for this Notice of Restriction of Use is that on 0 q t I)Z, r, , you violated Section 4 of e Park <br />and Opef Space Rules, and/or Section . l q, o of the Eugene Code, 1971, and/or ORS To wit, you: <br />V Z ct� A, Lt z> t5U <br />(Description of the violation.) <br />This restriction of use is effective beginning on Oq l 4- 1 I , and shall remain in effect until j () o 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 he 'ng the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in t 's to t ice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presentin tes imony, 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 Notic 'the date and time shown above by: <br />4 2Lf <br />Lure of person issuing /delivering notice) <br />`V. - 'F0 <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Si ature 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. 04/03 <br />