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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 1 09A 1 D <br />TIME: 15�) o ,s CASE #: 19— 1q05 <br />LOCATION (PARK/OPEN SPACE): AITZK mks <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 />The basis for this Notice of Restriction of Use is that on I ogl Ll ( you violated Section ,' 01 Ciy of the Park <br />4 ad Open Space Rules, and/or Section of the Eugene Code, 1971; and/or ORS 4 K "abl . To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on �d�}a1�, , and 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 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 hearin the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this No ice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting�testi ony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. f <br />This Notice of Exclusion was delivered to the person named at the top of this Notiileff the date and time shown above by: <br />qzq r= PO <br />of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />a <br />( > of p son Bing issued the notice) <br />3 <br />Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />Name: Last x � First �` , __ ^ , Ikli� q d <br />C�7J V, l�1 <br />DQ d <br />(J( <br />Race /Sex <br />a <br />U <br />Res. A dress: City <br />p AN SI Ffi1 <br />State <br />Zip <br />es. Phone: <br />Work Phone: <br />O 5 <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 />The basis for this Notice of Restriction of Use is that on I ogl Ll ( you violated Section ,' 01 Ciy of the Park <br />4 ad Open Space Rules, and/or Section of the Eugene Code, 1971; and/or ORS 4 K "abl . To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on �d�}a1�, , and 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 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 hearin the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this No ice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting�testi ony, from the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. f <br />This Notice of Exclusion was delivered to the person named at the top of this Notiileff the date and time shown above by: <br />qzq r= PO <br />of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />a <br />( > of p son Bing issued the notice) <br />3 <br />Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />