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 />y Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this N otice of Restriction of Use is that on G ?4S tq_, you violated Section ai SfIe Park <br />and Open Space Rules, and/or Section \ . ', <br />_ OQ of the Eugene C ode, 1171, and/or ORS ro wit yow <br />M <br />V­,K L- t om , k_ <br />(Description of the violation.) Ct4-,rj Co AJ—,- 1-j- <br />J <br />This restriction of use is effective beginning an G SZS t"" .ari 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 info al hearing to contest this Notice. A request for an <br />infori hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (eXCILISive of weekends) of receipt of this Notice at the to] I owing 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 ofvveekends) of receipt of the request for hearing. At the informal hearing the Division Director il 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 testiniony, 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 ofthis Notice at the date and time shown above by-, <br />(Signature of person issuifig/deli�ering-11t)tice <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />------ - -------- ------------------ - 2t -- — - — ----------------------- <br />(Si mature of Pe i < bei2 g g issued the notice) <br />White Copy P ab I w Works Green Copy� File Yellow Copyy Report Copy NA Copy-, Recipje ut Gold Copy � 0 ffiqxr Appo al ii,*i i c � R (ATO <br />Mane: Last First Middle <br />rx) <br />Racc,Sex! <br />Ntwcl Aj C /4-4 T_^_*Cd�_s <br />C) t:)C-\ Fs <br />. s: City <br />Statt <br />Zip <br />r1jQUe__ <br />Wofk Phone� <br />�Ad <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 />y Entering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this N otice of Restriction of Use is that on G ?4S tq_, you violated Section ai SfIe Park <br />and Open Space Rules, and/or Section \ . ', <br />_ OQ of the Eugene C ode, 1171, and/or ORS ro wit yow <br />M <br />V­,K L- t om , k_ <br />(Description of the violation.) Ct4-,rj Co AJ—,- 1-j- <br />J <br />This restriction of use is effective beginning an G SZS t"" .ari 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 info al hearing to contest this Notice. A request for an <br />infori hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (eXCILISive of weekends) of receipt of this Notice at the to] I owing 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 ofvveekends) of receipt of the request for hearing. At the informal hearing the Division Director il 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 testiniony, 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 ofthis Notice at the date and time shown above by-, <br />(Signature of person issuifig/deli�ering-11t)tice <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />------ - -------- ------------------ - 2t -- — - — ----------------------- <br />(Si mature of Pe i < bei2 g g issued the notice) <br />White Copy P ab I w Works Green Copy� File Yellow Copyy Report Copy NA Copy-, Recipje ut Gold Copy � 0 ffiqxr Appo al ii,*i i c � R (ATO <br />