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DATE: 9b) JJ] <br />509�v�) <br />NOTICE OF RE5'I'RICT1ON OF USE I <br />and Notice of Right to Appeal <br />TIME: :. - <br />LOCATION (PARKiOPEN SPACE): Lta Pyk <br />CASE #: /J � / 5TY3 <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 />dEntering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on ++ +l _, you violated Section 1 I �It)i <br />he Park <br />and Open Space. Rules, and/or Section _qAo— of the Eugene Code, 1971, and/or ORS . To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on Q f ' J : xnd 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 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 ("thc 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 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 remain in effect pending any requested hearing. � <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the and time shown above try <br />'1o5 <br />re of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: He Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. NiO <br />Namc: Last First Middle <br />DOK <br />Race's <br />0. <br />xRes. <br />Address; City <br />Alva Jar+ <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <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 />dEntering in or using all City of Eugene parks, open spaces or facilities. <br />The basis for this Notice of Restriction of Use is that on ++ +l _, you violated Section 1 I �It)i <br />he Park <br />and Open Space. Rules, and/or Section _qAo— of the Eugene Code, 1971, and/or ORS . To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on Q f ' J : xnd 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 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 ("thc 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 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 remain in effect pending any requested hearing. � <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the and time shown above try <br />'1o5 <br />re of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.. <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: He Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. NiO <br />