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z <br />Nfi;_ I ast FiNa Middle <br />13013• <br />Race <br />Z� <br />Res. Addresc Cio, <br />S a <br />Zip <br />Res. Phone <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 />aotified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces nr facifitl <br />The basis for this Notice of Restriction of Use is that on !'?- 10 7-j 1 q you violated Section 1, C70 1 (0 of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS —. To wit, you:_ <br />ALe-LV-kr, <br />1 Desenipti on of the violation <br />This restriction of use is effective beginning on I and shall remain in effect unfl]10 15 <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 informal 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'reccipt of this Notice at the following address� 1820 Roosevelt, Blvd., Eugene, Olt <br />97402. <br />The Division Director shall schedule a tirrie 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 informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in, this Notice, and other witnesses to the <br />incident. The Div ision Director may exclude anj�one, other than you and those presenting testimony from the i n forma I heari n <br />This Notice shall remain in eMet pending any requested hearing, <br />This Notice offxclusion was delivered to the person named at the top of this Notice at the date and firne shown above by: <br />(Si at re of person isquing/dclivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />fl-A <br />'I <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green CopyL File Yellow Cup/: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal nutioe Rev. 04.'03 <br />