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MI N� -�
<br />NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE:
<br />O 67 2 TIME: 5-,- L CASE #:
<br />LOCATION (PARK/OPEN SPACE): Z dT -
<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 />>C Entering in or using all City of Eugene parks, open spaces or facilities.
<br />07
<br />1, 0 e }l�J w-
<br />The basis for this Notice of Restriction of Use is that on , you violated Section • 0 of the Park
<br />and Open Space Rules, and /or Section ' O of the Eugene Code, 1971, and/or ORS To wit, you:
<br />0 J &4,c 6 (J - T�1 E PAU A -�-TP2 C- -os 6- Koo g�
<br />M AL,-( ,44-" rI D L A C. V�EVO4 - E
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on 02091'2 and shall remain in effect until
<br />el
<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 the date and time shown above by:
<br />,
<br />E� Eb
<br />(Signature of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicate C ove. J�, f_
<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. 04/03
<br />z
<br />Name: Last ,gam First Middle
<br />DOB: o �^
<br />Race:
<br />a
<br />Res. Address: (ZAtJ 1 &- City
<br />State
<br />Zip
<br />Res. Phone:
<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 />>C Entering in or using all City of Eugene parks, open spaces or facilities.
<br />07
<br />1, 0 e }l�J w-
<br />The basis for this Notice of Restriction of Use is that on , you violated Section • 0 of the Park
<br />and Open Space Rules, and /or Section ' O of the Eugene Code, 1971, and/or ORS To wit, you:
<br />0 J &4,c 6 (J - T�1 E PAU A -�-TP2 C- -os 6- Koo g�
<br />M AL,-( ,44-" rI D L A C. V�EVO4 - E
<br />(Description of the violation.)
<br />This restriction of use is effective beginning on 02091'2 and shall remain in effect until
<br />el
<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 the date and time shown above by:
<br />,
<br />E� Eb
<br />(Signature of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicate C ove. J�, f_
<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. 04/03
<br />
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