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NOTICE OF REs OF USE <br />and Notice of Right to App"d <br />DAIE: TIME: CASE 4 <br />LOC'ATION (PARK/OEIEN SPACJ 4 4-4 <br />Under the authority of Administrative Order No. - 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 fc -triction of Use is that on L �� <br />I )r this Notice of Res you vio[ated Section <br />Nanic: La;L Filet Middle <br />DOB: <br />Race 'Sex <br />J <br />of the Eugene Code, 1 971, and/or ORS <br />7 t <br />1X0, <br />L <br />Res, Address C I t y <br />I r4 <br />StWe <br />Z 1 <br />Pho <br />Work llhone� <br />Under the authority of Administrative Order No. - 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 fc -triction of Use is that on L �� <br />I )r this Notice of Res you vio[ated Section <br />.01 <br />the Park <br />and Open Space Rules, and/or Section <br />of the Eugene Code, 1 971, and/or ORS <br />To wit, you <br />L <br />If you enter if] Or use ally City of Eugene park, open space or 111cility dUriug the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Z7 <br />Pursuant to [lark and Open Space Rule R- 1.074 you are entitled to an informal hearing to contest this Notice, A request for an <br />in rortual hearing rnust be made in writing and filed with the Parks & Open Space Division Director ("the Divis'lon Director") <br />within 49 11OUrs (exclusive of weekends) of receipt ofthis Notice art the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a thrie and place t'br the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt ofthe request for hearing. At the informal hearing the Div ision Director wi I I (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, frorn the infornial, heaxing. <br />This Notice shall remain in effect pending any requested hearing. <br />Tius Notice of Exclusion was delivered to the perscin named at the top of this Notice at the date and time shown above by: <br />/JA-qli� <br />(Signawre of person issuing,"delivering notice) <br />I hereby acknowledge receipt cd'the above Notice on the date and time indicated above, <br />V(Aj <br />(Sign.ItUre of person being issued the notice) <br />Whiw Copy: Publk: Works Green ( opy Fite Ye&h)w Copy Repoh Copy Pink Copy: Rccipicni Gold Copy (Alker Appeal nolice ` , 0 4M 1, <br />