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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE: TIME: //1' 06 APLi
<br />r/� g
<br />we /0. /1/
<br />CASE #: i
<br />LOCATION (PARKJOPEN SPA CE):jt/
<br />1 1 5 5 11515
<br />LInder the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-14005(3), you are hereby
<br />notified that you are prohibited from (check box);
<br />Entering in or usineity of Eugene parks, open spaces or facilities.
<br />The basis for this Notice of Restriction of Use is that on O _, you violated Section /-0/ ' Uepark
<br />aiid,qpcn 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
<br />3N3
<br />beginning onOY , and shall remain in effect until 0,1'3 013
<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 />Pursnant 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 in I "Dri 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 married at the top ofthis Notice t the, date and time shown abovcby:
<br />(Signat ( _of peisors suing�,delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above,
<br />(Sip a, e ot being issued the notice)
<br />I r
<br />White Copy Public Works Green Coln-! File Yellow Copy: Repon Copy Pink Copy! Recipient Gold Copy: Officer Appeal ncAice Rev (W03
<br />Name: Last First Middle
<br />MA/
<br />SLAT rVLOR JAAA[-S
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<br />Race S -X
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<br />Res. A s
<br />ddre,�: City
<br />State
<br />Zip
<br />Res. Phone:
<br />Work Phone:
<br />11111 6. - w-q Imjx
<br />OP
<br />1
<br />-
<br />1 1 5 5 11515
<br />LInder the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-14005(3), you are hereby
<br />notified that you are prohibited from (check box);
<br />Entering in or usineity of Eugene parks, open spaces or facilities.
<br />The basis for this Notice of Restriction of Use is that on O _, you violated Section /-0/ ' Uepark
<br />aiid,qpcn 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
<br />3N3
<br />beginning onOY , and shall remain in effect until 0,1'3 013
<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 />Pursnant 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 in I "Dri 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 married at the top ofthis Notice t the, date and time shown abovcby:
<br />(Signat ( _of peisors suing�,delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above,
<br />(Sip a, e ot being issued the notice)
<br />I r
<br />White Copy Public Works Green Coln-! File Yellow Copy: Repon Copy Pink Copy! Recipient Gold Copy: Officer Appeal ncAice Rev (W03
<br />
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