New Search
and Notice of Right to Appeal <br />D 9 <br />ATE: 0 TIM J' E: 41 j <br />C CASE <br />LOCATION (PA RK —g <br />z <br />Naincl Ast First �4iddle <br />Aj L, D� <br />9- <br />- 7V <br />Race <br />U <br />Re Address" ChV <br />TR A <br />State <br />Lai <br />Zi5 <br />J <br />L <br />Res Pholle 4 <br />X5 <br />Work Phone: <br />� Do3b <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-10005(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 />El <br />(Zrip qoth/aol <br />This restriction of use is effeetive beginning on and shall remain in of until b 5 1 )3 <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 />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 info al 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 No 'ce this lo o time shown above by: <br />(Signature of pqFrscars issuing/delivering notice) <br />I hereby acknowledge receipt ofthe above Notice on the date and time indicated above. * '� 11 � i — <br />