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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATr-�: AV-011-7, ' 1!4!iq TIMF� , PZ-Z:Z- CASF #: <br />1-0(.'ATION (PAR K. <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 />0 Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />The basis for this Notice of Restriction of Use is that on 0 ' , /Y , you violated Section of the Park <br />and Open Space Rules, -and/or Section of the ELIgene Code, 1971, and/or ORS To wit, you <br />kA&�tbAt j r7f j A( <br />(Description of the violationj <br />This restriction of use is efftTtive beginning on and shall remain in effect until N1, <br />/ I <br />If you enter in or use any City Of Eugene park, open space or facility during the effective period ofthis Notice, you may be <br />c ar 4� <br />rested and charged with criminal trespass in the second decree. <br />pursuant to Park and Open Space Role R- 1 .074 You are entitled to kin intbrnial hearing to contest this Notice. A request f'or 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 followingaddress: 1920 Roosevelt, Blvd., Elagene, OR <br />97402. <br />The Division Director shall schedule a tine and place for the inf hearing to be conducted, which shall be not more than <br />72 hours (exc I usive of weekends) ofrecerptofthe request for hearing. At the informs I hearing the Division Director wit I only <br />consider testimony h 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 VOU and those presenting testimony, froin the informal hearing <br />This Notice shall rentain in effect pending any requested hearing. <br />This Notice of Fxclusion was delivered to the person named at the top ot'this Notice art the date and tinic shown above by <br />iSSUing"d elivering notic <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />X I Fk <br />(Signmure of person being isscae the rtcatice) <br />White ( Off: Public Works ( preen C 'opy: File 1 ellox Copy: Report Copy Pink Copv: Recipient Cold Copy 01'ficer Appeal nolice. Rv 0 411", <br />Name: Last Fivst Middle <br />DO 13 <br />Race,'Sex: <br />AAAC� -V' <br />Res. Address: City Zil) <br />Res, Phone: <br />Work Phone� <br />f <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 />0 Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />The basis for this Notice of Restriction of Use is that on 0 ' , /Y , you violated Section of the Park <br />and Open Space Rules, -and/or Section of the ELIgene Code, 1971, and/or ORS To wit, you <br />kA&�tbAt j r7f j A( <br />(Description of the violationj <br />This restriction of use is efftTtive beginning on and shall remain in effect until N1, <br />/ I <br />If you enter in or use any City Of Eugene park, open space or facility during the effective period ofthis Notice, you may be <br />c ar 4� <br />rested and charged with criminal trespass in the second decree. <br />pursuant to Park and Open Space Role R- 1 .074 You are entitled to kin intbrnial hearing to contest this Notice. A request f'or 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 followingaddress: 1920 Roosevelt, Blvd., Elagene, OR <br />97402. <br />The Division Director shall schedule a tine and place for the inf hearing to be conducted, which shall be not more than <br />72 hours (exc I usive of weekends) ofrecerptofthe request for hearing. At the informs I hearing the Division Director wit I only <br />consider testimony h 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 VOU and those presenting testimony, froin the informal hearing <br />This Notice shall rentain in effect pending any requested hearing. <br />This Notice of Fxclusion was delivered to the person named at the top ot'this Notice art the date and tinic shown above by <br />iSSUing"d elivering notic <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />X I Fk <br />(Signmure of person being isscae the rtcatice) <br />White ( Off: Public Works ( preen C 'opy: File 1 ellox Copy: Report Copy Pink Copv: Recipient Cold Copy 01'ficer Appeal nolice. Rv 0 411", <br />