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I <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 />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on you violated Section / <br />44--&—1 J 4940 � of the 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 Y 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 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />I fie U17171011 M77771 61711 MY MfX nU1T1TdT_1TU'MTrTg_�o De Coll <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 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 />41 <br />(Sigfiature of person issu?nglde ivering no <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy File Yellow Copy: Report Copy Pink Copy: Recipient Gofd Copy: Officer Appeal notice Rev. 04/03 <br />darn tat <br />first <br />Middle <br />DiPP, <br />RacellS e <br />IJ <br />Res Addrex. <br />e- city <br />state <br />Z <br />IN <br />Res. Phone: <br />W,,L Ph <br />I <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 />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on you violated Section / <br />44--&—1 J 4940 � of the 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 Y 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 49 hours (exclusive of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />I fie U17171011 M77771 61711 MY MfX nU1T1TdT_1TU'MTrTg_�o De Coll <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 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 />41 <br />(Sigfiature of person issu?nglde ivering no <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy File Yellow Copy: Report Copy Pink Copy: Recipient Gofd Copy: Officer Appeal notice Rev. 04/03 <br />