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- 7 <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: CASE. #: <br />LOCATION (PARKIOPEN SPACE <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 />Entering 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 0 1 -i C5513 , you violated Section I a 0 0 ( �Ie Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS --, To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on 04 L , and shall remain in effect until — C - ��Srs . <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 />IT"O <br />5on Direcior will on y <br />01 W CCKCHUN; Of I CUC1JJL Ot L11r, iuquesL 177 Mai Ing, 77 Me inron ring Me -Fivis <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 an) 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 />(Sig person �pers — nissuin gi,t delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time Indic <br />White Copy: Publi+ - Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Offixer Appeal notice Re% . 04 , '0 1 <br />Marne: Last First Middle <br />DOB: <br />Racc/SQx: <br />0 - <br />W-Nlk a A NJ Y <br />U <br />Res. Address: city <br />State <br />Zip <br />Res. Phone: <br />----------- <br />Work Phone: <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 />Entering 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 0 1 -i C5513 , you violated Section I a 0 0 ( �Ie Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS --, To wit, you:_ <br />(Description of the violation.) <br />This restriction of use is effective beginning on 04 L , and shall remain in effect until — C - ��Srs . <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 />IT"O <br />5on Direcior will on y <br />01 W CCKCHUN; Of I CUC1JJL Ot L11r, iuquesL 177 Mai Ing, 77 Me inron ring Me -Fivis <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 an) 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 />(Sig person �pers — nissuin gi,t delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time Indic <br />White Copy: Publi+ - Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Offixer Appeal notice Re% . 04 , '0 1 <br />