NOTICE OF RESTRICTION OF USE <br />and Notice of'Right to Appeal <br />DATE: I C- TIME: t `ASE: # <br />5 �5��.�5��5 <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 prohihited from (check box): <br />W Entering; in or using all City of Eugene parks, open spaces or facilities. <br />X <br />If you enter in or use any City of Eugene park., open space or facility during the effective period offlus Notice, you inay 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 inku-nu.'d hearing to contest this Notice, A request for an <br />inforrnal hearing must be made in writing and tiled 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 address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a erne and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive ol"weekends) of receipt of the request For hearing. At the informal hearing the Divis[on Director wiH only <br />consider testimony from You, City personnel involved in the incident that resulted in this Nofice, and other witnesses to the <br />- <br />Incl i 'dent. The Divis on Director may exclude anyone, other than you and those presenting testimony, firorn the informal hearing. <br />I <br />This Notice shall remain in effeet pending any requested hearing. <br />This Notice of Exchision was dehvered to the person named at the top of this Notice at the date and time shown abcwe by: <br />PcJids <br />(Signature ofperson issuing/olchvering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the ncitice) <br />Whi[, 03 )Y: PLINk: WOFk., (ireel% ( opy- File `a t; Cody Rt:qlorl Copy Pink Copy: Recipicut Gold Copy Offl('r Appeal r hll ice Ri , 04, 03 <br />— <br />Name: Last Fim( Nliddle <br />- ---------- <br />DOB <br />R a c e i Sic K <br />/A)z 4 5-1 E UC- <br />/ <br />W <br />U <br />Rea. Address: City <br />State <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 prohihited from (check box): <br />W Entering; in or using all City of Eugene parks, open spaces or facilities. <br />X <br />If you enter in or use any City of Eugene park., open space or facility during the effective period offlus Notice, you inay 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 inku-nu.'d hearing to contest this Notice, A request for an <br />inforrnal hearing must be made in writing and tiled 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 address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a erne and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive ol"weekends) of receipt of the request For hearing. At the informal hearing the Divis[on Director wiH only <br />consider testimony from You, City personnel involved in the incident that resulted in this Nofice, and other witnesses to the <br />- <br />Incl i 'dent. The Divis on Director may exclude anyone, other than you and those presenting testimony, firorn the informal hearing. <br />I <br />This Notice shall remain in effeet pending any requested hearing. <br />This Notice of Exchision was dehvered to the person named at the top of this Notice at the date and time shown abcwe by: <br />PcJids <br />(Signature ofperson issuing/olchvering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the ncitice) <br />Whi[, 03 )Y: PLINk: WOFk., (ireel% ( opy- File `a t; Cody Rt:qlorl Copy Pink Copy: Recipicut Gold Copy Offl('r Appeal r hll ice Ri , 04, 03 <br />