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NOTICE OF RESTRICTION OF USE <br />DATE: Otwsvl) <br />LOCATION (PARK /OPEN SPACE)) <br />'TI ME� I <br />0 <br />i <br />U nder tire authority of -,�Vdminis,trafive Order No. 5A43-244 and Padrk-a l�uje R-1.136(3), you are hereby <br />notified that you are prohibited from (check box): <br />9 0 Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />The basis for this Notice of Restriction of Use is that on —04—ZA3, you violated Section IDLS\t�of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS — 1 To wit, you:_ <br />Vc <br />I , <br />(Description of the violation.) <br />6 G <br />This restriction of use is effeetive beginning on 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 />itnesses to t <br />IMPKI 1167 liummal nearing TIFF D171 win oil <br />X <br />urnearing. <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />rm <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearin <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 />0413\6� ---b-zb <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signatur 0 Person being issued the notice) <br />White Copy: Public Works Greffl Cully: Fite Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04,,03 <br />Name: Last First Middle <br />DOB: <br />Race/Sex: <br />4- <br />City <br />P!�s A City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />�res�: <br />U nder tire authority of -,�Vdminis,trafive Order No. 5A43-244 and Padrk-a l�uje R-1.136(3), you are hereby <br />notified that you are prohibited from (check box): <br />9 0 Entering in or using all City of Eugene parks, open spaces or facilities. <br />El <br />The basis for this Notice of Restriction of Use is that on —04—ZA3, you violated Section IDLS\t�of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS — 1 To wit, you:_ <br />Vc <br />I , <br />(Description of the violation.) <br />6 G <br />This restriction of use is effeetive beginning on 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 />itnesses to t <br />IMPKI 1167 liummal nearing TIFF D171 win oil <br />X <br />urnearing. <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to t <br />rm <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearin <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 />0413\6� ---b-zb <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signatur 0 Person being issued the notice) <br />White Copy: Public Works Greffl Cully: Fite Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04,,03 <br />