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NO"SIC E OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATF: 0 TIME: <br />Y—Q <br />LOCA (PARK/OPEN SPACE). <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 />E n, tering in or using all City of Eugene park%, open spaces or facilities. <br />F9 <br />The basis for this Notice of Restriction of Use is that on -- 0 O I V , you violated Section — of the Park <br />of the Eugene Code, 1971, and/or ORS To wit, } ou: <br />and Open Space Rules, and Section <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 addre."� 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shill whedule 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 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 reninin in effect pending any requested hearing. <br />I hereby acknowledge receipt of the above Notice on the date and time <br />(Signature orperson i <br />EM <br />above by,- <br />issued the notice) <br />While Copy Public Work Green Copy, File Yellow 4 opy_ R��P�l n Copy Pink Copy: kccipient� CkAd Copy: Officer Appeal notice 0003 <br />N La <br />d rn ';t F Int Middle <br />DOB: <br />L <br />Ra s ex <br />A <br />J Tdrp s C <br />/g� <br />Res, I Me: <br />Wor Ph <br />k one ; <br />47i1[ <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 />E n, tering in or using all City of Eugene park%, open spaces or facilities. <br />F9 <br />The basis for this Notice of Restriction of Use is that on -- 0 O I V , you violated Section — of the Park <br />of the Eugene Code, 1971, and/or ORS To wit, } ou: <br />and Open Space Rules, and Section <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 addre."� 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shill whedule 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 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 reninin in effect pending any requested hearing. <br />I hereby acknowledge receipt of the above Notice on the date and time <br />(Signature orperson i <br />EM <br />above by,- <br />issued the notice) <br />While Copy Public Work Green Copy, File Yellow 4 opy_ R��P�l n Copy Pink Copy: kccipient� CkAd Copy: Officer Appeal notice 0003 <br />