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' NOTICE OF RESTRICTION OF USE <br />and Notice of fright to Appeal <br />DATE: c d TIME. CASE ft <br />LOCATION (PARKJOP N SP' <br />mv <br />i' <br />Nanyal 1 #il" � / 11 <br />DOB <br />t2��e /S <br />} { <br />+ p <br />7;c <br />L,7 <br />Res. Address: City ` State `Lip <br />I---- <br />Res. Pbone: <br />one. <br />Work Ph <br />f <br />- - -_- <br />C 1 _. _.. -_. I <br />Under the authority of Administrative Order No. 513- 03 -24 -I' and Park nand 01)ou Space Rule R- 1.005(3), you are hereby <br />notified that you are prohibited from (check box); <br />► j Entering in oa using all City of Eugene parks, open spaces or facilities. <br />f' 171 <br />The basis.for this Notice of restriction of Use is that oia + , you violated Section f the Palk - (AM6 <br />and f: on Space Rules, and/or Section _ __ of the Eugene Code. 1.971, andltir ORS � . To wit, yet): <br />(Description of the violation.) <br />Tlais restriction of use is d fectaV�,M <br />If you enter in car use any City of Eugene park, open space or farcility during the effective period of this Notice, you tray be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space rule ft -1.074 you are entitled to an infort al heating to contest this Notice. A re g0st for all <br />informal hearing must he made in writing and :heel with the Parks & Open Space Division Director ( "the Division 409 z ") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address. 1820- toosevelt, blvd., ugene, Olt <br />97402, <br />The Division ision Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive oftveekends) of receipt of'the request for hearing. At the informal hearing the Division Director will only <br />r testirtiony from you, City personnel involved in Clio 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, frown the informal hearing. <br />This Notice shall remain in effect peod ng any requested heating <br />This Notice of Exclusion was delivered to the person named at the top of this Not eat the (late and time show above by: <br />i <br />( iaatcrrc of person isstaiti� cleliwer itit notice) <br />I hereby acknowledge receipt of the above Notice on the cane and time indicated above. <br />4- - 4 - qr-- �1 W / <br />(Signature of'person being issued the notice) <br />Vllire r upy; !'uhlic Work's C3re,sn Cully; rile Yellow Cony. Reporl COPY Vink Copy: ltei ipiwil . Gold Ct lly: Officer Appeal ho io, Rev. t'1�lrr}3 <br />