NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />)ATE: / 0 3� i / Z- <br />TIME: <br />J n CASE #: 1 I q5,,;oP-z. <br />,OCATION (PARKIOPEN SPACE): 1 � )3(v ces E 5 z W /-, <br />Jnder the authority of Administrative Order No. 5 &03 -24 -F and Park and Open Space Rule R- 1.005(3), you are hereby <br />otified tha you are prohibited from (check box): <br />Entering in or ukai all C' of Eugene parks, open spaces or facilities. <br />F <br />Che basis for this Notice of Restriction of Use is that on i ®� ! t , you violated Section �' t 1 -0 of the Park III <br />nd Open Space Rules, and/or Section r— of the Eugene Code, 1971, and/or ORS To wit, you: <br />Vi ID 1rp;5k OW 4,VC, V(xk[ -5 -5 eES l n }\WM <br />Description of the violation.) <br />Phis restriction of use is effective beginning on �I t� and shall remain in effect until <br />f 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 />Trested and charged with criminal trespass in the second degree. <br />'ursuant 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 />nformal hearing must be made in writing and filed with the Parks & Open Space Division Director ( "the Division Director ") <br />vithin 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />►7402. <br />.he Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />'2 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />:onsider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />ncident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />Phis Notice shall remain in effect pending any requested hearing. 7 y <br />',his Notice of Exclusion was delivered to the person named at the top of this Notice at th/daXand time shown above by: <br />Y2 <br />of person issuing /delivering notice) <br />hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />r <br />Si tore o person eing issued the notice) <br />1 <br />opy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />Name: Last First Middle <br />DOB: <br />Rac / ex: <br />a <br />E5 <br />Res. Address: City <br />State <br />I Zip <br />Res. Phone: <br />Work Phone: <br />Jnder the authority of Administrative Order No. 5 &03 -24 -F and Park and Open Space Rule R- 1.005(3), you are hereby <br />otified tha you are prohibited from (check box): <br />Entering in or ukai all C' of Eugene parks, open spaces or facilities. <br />F <br />Che basis for this Notice of Restriction of Use is that on i ®� ! t , you violated Section �' t 1 -0 of the Park III <br />nd Open Space Rules, and/or Section r— of the Eugene Code, 1971, and/or ORS To wit, you: <br />Vi ID 1rp;5k OW 4,VC, V(xk[ -5 -5 eES l n }\WM <br />Description of the violation.) <br />Phis restriction of use is effective beginning on �I t� and shall remain in effect until <br />f 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 />Trested and charged with criminal trespass in the second degree. <br />'ursuant 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 />nformal hearing must be made in writing and filed with the Parks & Open Space Division Director ( "the Division Director ") <br />vithin 48 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />►7402. <br />.he Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />'2 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />:onsider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />ncident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />Phis Notice shall remain in effect pending any requested hearing. 7 y <br />',his Notice of Exclusion was delivered to the person named at the top of this Notice at th/daXand time shown above by: <br />Y2 <br />of person issuing /delivering notice) <br />hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />r <br />Si tore o person eing issued the notice) <br />1 <br />opy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />