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NOTICE OF RESTRICTION OF USE <br />and Notice offfight to Appeal <br />DATL TIME: CASE A: <br />LO('A PAA <br />�?' <br />1 , , <br />9- <br />Name Laqt First MIddle <br />1 <br />i I ICN61 PWn r— <br />MN3 <br />I Z A 1L <br />R ces,_ eV <br />Res, iWdress: City <br />State <br />r ::....... <br />Zip <br />Res, Phone: <br />1 Work Plione: <br />U ri der the authority (if rfministrative Order No. 58-03-244'and Park and Open Space Role R-1.005(3)a 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 />The basis f'or this Notice of Restriction of Us 's t} <br />t at I at on you violaled Section 1. 010" of the Park <br />and Open Space Rules, and/or Section q, 24 0 of the Eugene Code. 1971, andlor ORS To wit, yow <br />e , MtV_ws' <br />(Description of the violation.) <br />r0A K_ 10 TH fAP-k-- <br />This restrictio n of use is effective begin ning on 4 , and shal remain in effect until ,- IL7— <br />A <br />II'vou enter in or use any City of'Eugenc park, open space or fricility during the effective period of'thiS NOfiCe. YoLt may be <br />arrested and charged with criminal trespass in the second degree, <br />PUrSUant to Park and Open Space hale R -1,07 VOU 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 & Olvii Space Division Director ("the Division Director") <br />within 48 hours (exclusive of'weekends) of receipt of this Notice tat the following address: 1820 Roosevelt, Blvd., Eugene, Oil <br />97402. <br />The Division Director shall schedule as firne and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (CXC]U of' weekends) of receipt of the request for hearing. At the informal -hearing the Division Director wil I only <br />consider testimony froni 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 lestiniony, horn the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of E"XCILISion was delivered to the person named at the top of this Notice at the clate and time shown above by: <br />.... ......... <br />s <br />of person issuing/delivering notice) <br />I hereby ackriowledge receipt of the above Notice on the date and time indicated above. <br />(Signat r '61"person being iSSUed the notice) <br />White( op): Public Wmks G]"11 Colly: H" Y,�Alow Copy: Repot I Copy N11 Copy: Re6jji(mL (jold Copy: Offic�a App( nonce Re" 0 4 W <br />