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NOTICE OF RESTRICTIONOF USE <br />and Notice of Right to Appeal <br />5�5 I 3V&V,- #11:511 <br />DATF L l <br />------- - -- <br />TIME: <br />L 17 <br />CASE #: <br />LOCA1 ION (PARKiOPEN SPACE):,_,, <br />Res. Address: City <br />X <br />Nanie. Last First Middle <br />D0[1� <br />Race/s -X <br />"70';/�,, <br />Res. Address: City <br />State <br />Zip <br />Res. Hione <br />Work llhone: <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 />Entering in or using all City of Eugene parks, open spaces or Facilities. <br />Ful <br />The basis for this Notice of Restriction of Use is that on you violated Sect](Al <br />and Open Space lZriles, and/or Section of the Eugene Code, 1971, andJor ORS <br />(Description of the violation.) <br />To wit, you: <br />Ifyou enter in or use any City cat" ugeric 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 />PursuaDt 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 rnust be made in writing <br />, and filed with the Parks & Open S pace Division Director ("the, Di vision Director") <br />within 48 hours (exclusive ofwcekends) of receipt of this Notice at the I "ollowing 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 thall <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director wl H only <br />0 <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 infortnal hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />his Notice of'Exclusion was delivered to the person named at the top of this Notice at the date and tirne shown above by <br />(Signature of person issuing/delivering notice) <br />F <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />s/1 <br />(Signature of person being issued the notice) <br />While Copi Public Works Gem Copy: File Y e, I I o V C o P'� R e p(wi C u py Nnk Copy: Roes writ Gold Copy: Officer Appeal notice Rev, 04 ,03 <br />