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NOTICE OF RESTRICTION OF USE <br />DATE: 1® Z2- ®— TIME: efas <br />CASE: 0Z' 1 7107 <br />DATE OF BIRTH: 0YO 7 <br />Pursuant to the authority of Park Rule 1.005(3) and Administrative Order No. 58- 96 -17, you are <br />hereby notified that you are prohibited from entering in or using City of Eugene park and recreation <br />facilities, and from participation in City sponsored recreation programs or activities, based on: <br />�t <br />violation of Park Rule C AW A D ARE' '?JLi Si7r1iv1Z <br />(arrest for disorderly conduct/assault/drug related offense, etc.) <br />on <br />This restriction of use is effective as of the date indicated above, and shall remain in effect until <br />If you enter in or upon a City park and recreation facility, or attempt to participate in a City- sponsored <br />recreation program or activity during the effective period of this Notice, you may be arrested for <br />trespassing. <br />You are entitled to a hearing with respect to this determination. A written request for hearing must <br />be filed with the Eugene Police Department, at the address indicated below, within 48 hours <br />(exclusive of weekends) of receipt of this Notice. This Restriction of Use shall remain in effect <br />pending any requested hearing. <br />As used herein, "park facilities belonging to the City of Eugene" includes park facilities outside the <br />corporate limits of the City, and County parks within the corporate limits of the City. <br />Chief of Police <br />Eugene Police Department <br />777 Pearl Street, Room 107 <br />Eugene, OR 97401 <br />This Notice of Restriction of Use was delivered to the above named person at the date and time <br />indicated by: <br />� F1 (emu <br />ature of person delivering/issuing 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: Parks & Recreation Yellow Copy: File Pink Copy: EPD Report Copy Gold Copy: Receipt <br />aAnorou.frm <br />