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Na first Middle DOW <br />4 k- -4 LFAz_ a7b c� F 0 <br />�� 1z <br />az <br />R s Akidr"s: C W <br />ity State Zip Res, Phone: of L�� <br />Under the authority ofAdministrative 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 />IV Entering in or using all City of Eugene parks, open spaces or facilities. <br />M <br />The basis for this Notice of Reshiction of Use is that on you - violated Section 1, 1 002 Of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS I— ­ I—— ­ 1_. To wit, yow <br />e a �5, 5 5 Pf ��X G �i4e, t <br />(Description of the violation.) <br />This restriction of use is effective beginning on 0:&_W�, and 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 info al 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 sehedule 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 informai hearing the Division Director will only <br />-onsider 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 Not at the date and n )c <br />n a shown above by- <br />a g care ure of'person issuing notice_' <br />I hereby acknowledge receipt of the above Notice on the date and these indicated above, <br />10, 4igiature of person being issued the no <br />White Copy Public Workt, Grom Copy: Ffle Yeflow Copy: Repw Copy Pink Copy: K ecip ient Gold Cagy: Officer Agvaj notice <br />