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Under the authority of. d inistrative Order No. - 8-03-24-F and Park and Open Space Rule R-1 (), you are hereby
<br />notified that you are prohibited from (check box),
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />10
<br />The basis for this Notice of Restriction of Use is that on 632t
<br />LLa You violated Section ofthe Park
<br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS —. To wit, you._
<br />M
<br />This restriction 5of use is effective beginningen 3.Z,( p t3, and shall remain in effectuntil A–���
<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 49 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 reqnested hearing.
<br />This Notice of Exclusion was delivered to the person named at the top of this N i e at the date and time shown above by:
<br />of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time
<br />,tted above.
<br />(Signature of person being the notice)
<br />White Copy Public Works Green coey° File Yellow Copy: Repon Copy Pink Copy: Recipient Gold Copy; Office er Appeal notice Rev, 04.103
<br />Nainei Last First fiddie
<br />DOB:
<br />Race"Sex:
<br />24
<br />Res. Address: City State
<br />Zip
<br />Res, Phone!
<br />Work Phone:
<br />5Z IT-3 7
<br />Under the authority of. d inistrative Order No. - 8-03-24-F and Park and Open Space Rule R-1 (), you are hereby
<br />notified that you are prohibited from (check box),
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />10
<br />The basis for this Notice of Restriction of Use is that on 632t
<br />LLa You violated Section ofthe Park
<br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS —. To wit, you._
<br />M
<br />This restriction 5of use is effective beginningen 3.Z,( p t3, and shall remain in effectuntil A–���
<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 49 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 reqnested hearing.
<br />This Notice of Exclusion was delivered to the person named at the top of this N i e at the date and time shown above by:
<br />of person issuing/delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time
<br />,tted above.
<br />(Signature of person being the notice)
<br />White Copy Public Works Green coey° File Yellow Copy: Repon Copy Pink Copy: Recipient Gold Copy; Office er Appeal notice Rev, 04.103
<br />
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