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<br />NOTICE OF RESTRICTION OF USE
<br />DATE: / 0
<br />LOCATION (PARK/OPEN SPACE):_
<br />and Notice of Right to Appeal
<br />TIME: l j 1 0 0
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<br />CASE #: ! ` ,- � - 7
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<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 />K Entering in or using all City of Eugene parks, open spaces or facilities.
<br />�0 I `
<br />The basis for this Notice of Restriction of Use is that on , you violate��c� n of the Park
<br />and Open Space Ru es, and/or Section of the Eugene Code, 197 1, and/ pr ORS , , r, � o t, you:
<br />8 "-Lt v, it , L -_ �T(tl -All r ` l �o cue l
<br />(Description of the violation.)
<br />N
<br />This restriction of use is effective beginning on /"O x2,5-1 0 - , and shall remain in effect until 11 .25-1,2 .
<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 ( "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 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 Notic at the date and time shown above by:
<br />663,
<br />(Signa e of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />(I IN
<br />(Signature of person being issued the notice)
<br />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03
<br />Name: Last First
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<br />Res. Address: City
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<br />Res. Phone:
<br />Work Phone:
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<br />i s
<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 />K Entering in or using all City of Eugene parks, open spaces or facilities.
<br />�0 I `
<br />The basis for this Notice of Restriction of Use is that on , you violate��c� n of the Park
<br />and Open Space Ru es, and/or Section of the Eugene Code, 197 1, and/ pr ORS , , r, � o t, you:
<br />8 "-Lt v, it , L -_ �T(tl -All r ` l �o cue l
<br />(Description of the violation.)
<br />N
<br />This restriction of use is effective beginning on /"O x2,5-1 0 - , and shall remain in effect until 11 .25-1,2 .
<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 ( "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 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 Notic at the date and time shown above by:
<br />663,
<br />(Signa e of person issuing /delivering notice)
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />(I IN
<br />(Signature of person being issued the notice)
<br />White Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03
<br />
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