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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE. TIME: CASE <br />LOCATION (PAIWOPEN SPACE): <br />Under the authority of Administrafive <br />rder 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 />)Z_ Enterizig in or using all City of Eugene parks, open spaces or facilities. <br />IN <br />The basis for this Notice of Restriction of Use is that on -6 _3 /J you violated Section l p of the Park <br />Open Space Rules, and/or Section <br />(Description of the violation.) <br />♦ j r # M7Kj - TjL7R, <br />To wit, vou: <br />This restriction of use is effective beginning on 03@-11 and shall remain ineffeet 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 R4.074 you are entitled to an informal hearing to contest this Notice, A request for <br />infon 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 recei of this Notice at the followin% address� 1820 Roosevelt. e� <br />Blvd., 01 <br />�ug <br />97402. 1 <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />th e i f-o *t*jaLL h e D i vi ' is i. <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 - 4 1he date and time shown above by: <br />/ K <br />1 3M <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />N <br />(Signature of person b t ng issued the notice) <br />Winte Copy: Public Works Green Copy: File YCI]DW Copy: Report Copy Pink Copy: Recipient Gold Copy! Officer Appeal notice Rev. <br />Name: Last <—) First Mddle <br />DOB: <br />Race/Sex: <br />z <br />/ LAW.& <br />Res. Addr -s— city State 'i <br />Zip <br />Res. Phone: <br />Work Phone: <br />9 w <br />Under the authority of Administrafive <br />rder 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 />)Z_ Enterizig in or using all City of Eugene parks, open spaces or facilities. <br />IN <br />The basis for this Notice of Restriction of Use is that on -6 _3 /J you violated Section l p of the Park <br />Open Space Rules, and/or Section <br />(Description of the violation.) <br />♦ j r # M7Kj - TjL7R, <br />To wit, vou: <br />This restriction of use is effective beginning on 03@-11 and shall remain ineffeet 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 R4.074 you are entitled to an informal hearing to contest this Notice, A request for <br />infon 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 recei of this Notice at the followin% address� 1820 Roosevelt. e� <br />Blvd., 01 <br />�ug <br />97402. 1 <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />th e i f-o *t*jaLL h e D i vi ' is i. <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 - 4 1he date and time shown above by: <br />/ K <br />1 3M <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />N <br />(Signature of person b t ng issued the notice) <br />Winte Copy: Public Works Green Copy: File YCI]DW Copy: Report Copy Pink Copy: Recipient Gold Copy! Officer Appeal notice Rev. <br />