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NOTICE OF RESTRICTION OF USE 3�51 1 < �5 <br />and Notice of Right to Appeal <br />DATE: 012-lol TIME : CASE 043/0 <br />- ------- ----- <br />LOCATION (PARKYOPEN SPACE):, <br />U n der the a uthority of Administrative Order N o. 58-03-24-F and Park and Open Space Rate R,- 1.005(3 you a re hereby <br />notified that you are prohibited from (check box): <br />-k-- Entering in or using all City. of Eugene parks, open spaces or facilities. <br />10 <br />The basis for this Notice of Restriction. of Use is that on you violated Section / 1010 of the Park <br />and Open Space Rules, and/or Section 0 the Eugene Code, 1971, and/or ORS To wit, you: <br />) <br />A- Q PAQ4,< <br />(Description of the violation.) <br />This restriction of use is effective beginning on Ot and 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 inform al 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 ofthis 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 infornial he 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 />hicident� The Division Director may exclude anyone, other than you and those presenting testimony, trout the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion wag delivered to the person named at the top of this Notice at the date and time shown above by: <br />(Signature of pers � hleliv rin :io tctf) <br />Whac Copy-, Public Worb Grecrn Copy File Yellow Copy! Report Copy NA Copy: kccipiene 6old Copy: Officer Appeal notice KU OV0 I <br />Manic Last First Middle <br />DOZ <br />Dace sex' <br />Res- Address: C1 <br />�2— -C Y <br />'S <br />zi <br />1! , <br />Res, phonc - <br />X , <br />Nk'onk 'hone: <br />- , <br />U n der the a uthority of Administrative Order N o. 58-03-24-F and Park and Open Space Rate R,- 1.005(3 you a re hereby <br />notified that you are prohibited from (check box): <br />-k-- Entering in or using all City. of Eugene parks, open spaces or facilities. <br />10 <br />The basis for this Notice of Restriction. of Use is that on you violated Section / 1010 of the Park <br />and Open Space Rules, and/or Section 0 the Eugene Code, 1971, and/or ORS To wit, you: <br />) <br />A- Q PAQ4,< <br />(Description of the violation.) <br />This restriction of use is effective beginning on Ot and 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 inform al 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 ofthis 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 infornial he 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 />hicident� The Division Director may exclude anyone, other than you and those presenting testimony, trout the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion wag delivered to the person named at the top of this Notice at the date and time shown above by: <br />(Signature of pers � hleliv rin :io tctf) <br />Whac Copy-, Public Worb Grecrn Copy File Yellow Copy! Report Copy NA Copy: kccipiene 6old Copy: Officer Appeal notice KU OV0 I <br />