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I I Y2<f� Uj 2- Go <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 />The basis for this Notice of Restriction of Use is that on D_ �/ � , you violated Section 100�7(6 of the Park <br />and Open Space Rules, and/or Sectior/4 l of the Eugene Code, 1971, and/or ORS _. To wit, you, <br />-- -- - ----------- ---- <br />(Description of the violation,) <br />This restriction of use is effective beginning on and shall remain in effect until 1 %hj <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 infornial 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 infort 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 ma_x exclude anXone. other than �[o a testi rn Q11* from the infort hearing. <br />This Notice shall remain in eMct 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 />(Signature. of person issuing/delivering notice) <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 Work-, Green Copy: File Y c1low (_ Report Copy Pink Copy: Recipient Gold Cnpy: Officer Appeal notice Rm 04M3 <br />z <br />Naine: Last <br />L v � 441,q <br />irst MiddIc <br />DOB: <br />I <br />lZes, Address: <br />City <br />State <br />Zip <br />Work Phone: <br />I I Y2<f� Uj 2- Go <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 />The basis for this Notice of Restriction of Use is that on D_ �/ � , you violated Section 100�7(6 of the Park <br />and Open Space Rules, and/or Sectior/4 l of the Eugene Code, 1971, and/or ORS _. To wit, you, <br />-- -- - ----------- ---- <br />(Description of the violation,) <br />This restriction of use is effective beginning on and shall remain in effect until 1 %hj <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 infornial 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 infort 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 ma_x exclude anXone. other than �[o a testi rn Q11* from the infort hearing. <br />This Notice shall remain in eMct 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 />(Signature. of person issuing/delivering notice) <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 Work-, Green Copy: File Y c1low (_ Report Copy Pink Copy: Recipient Gold Cnpy: Officer Appeal notice Rm 04M3 <br />