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NOTICE OF RESTRICTION OF USE <br />DATL <br />LOCATION (PARKJOPEN SPACE) <br />and Notice of Right to Appeal <br />TIME: CASE <br />z <br />Nai Last 17 Ile <br />rs <br />9L A, -q( <br />D08 <br />a',' X: <br />Res. Address Ca v <br />Star <br />-7 <br />Re. Phone: <br />W Ork Phone: <br />Under the authority of, dministrative 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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(Description of the violation.) <br />This restriction of use is effective beginning on � 1" and shall remain in effect until <br />�- 1 <br />If you enter in or rise any City of Eugene park, open space or facility daring the effective period of this Notice, you 1 be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-I .074 you are entitled to an inforni,il hearing to contest this Notice. A request ft.r an <br />informal hearing 111USt be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclUSIVC of weekends) of receipt ofthis 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 sliall be not more (Platt <br />72 hours (exclusive of'weekends) of receipt of the request for hearing. At the infornial hearing the - Division Director will only <br />consider testimony frorn you., City personnel involved in the incident that restilted in this Notice, and other witnesses to the <br />incident. The D ig i s ion Director may ex e I tide anyone, other than you and those presenting testimony, f ion the informa heari n f <br />This Notice shall remain in effect pending any requested hearing. <br />"flus Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />(Signature of'person issadno/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />---------- . . .. ..... <br />(signature o person being issued the notice) <br />Wime opy Public Woika Ureen('opy: 1 ile YclkvA Copy: Report Copy Pink Copy: Rccipiew Go[d Copy: Officer Apjwa� nonc � Rc 0410" <br />