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NOTICE OF RESTRICTION OF USE <br />and Notice of Right. to Appeal <br />SOODATL TIML CASE#: 15):: <br />LOCAIJON (PARRIOPEN Cics .......... . .................. . . .... <br />Name: Last First Middle 1)013Rac c/scx: <br />a. <br />z C' <br />AJ'91110 $L) "0 <br />- - -------- <br />Res, Mdreqs: City State Zip Res. Phone: Work Phorie: <br />r4 <br />Under the authority of Administrative Order No. 58-03-244'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 />01 <br />The basis for this Notice of Restriction of Use is that on. ..... . . ...... .. you violated Section of fl.,�e Park <br />and Open Space lZules, arid/or Sectionof the Eugene Code, 1971, and/or ORS owit, yow . . . ........ <br />............. . . . . . . . . . . . <br />(Description of the violation.) <br />This restriction of use is effective beginning on g and shall remain in effect unfil-2/wT _2 <br />IfYOLII enter in coir use any City of Eugenc park, open space or facility during the el" ective period of this rq<.)five, you rriai'V be <br />arrested and charged with criminal trespass in the second degi ec. <br />Pursuant to Park and Open Space Rule R- 1 .074 you are entitled to an informal hearing to contest this Notice. A request f'(,.)r an <br />informal hearing must be made in writing and filed with the Parks & Open Space, Division Director ("the DivisionDirector") <br />within 48 hours (CXCILISiVC of` weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd®, Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the infonnal hearing to lure cojiduced, which shall be notrr'to.rc thall <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 Division Director rnay exclude anyone, other than you and those presenting testirrkon'Y, from the inti,)rmal hearing,, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice ofl..'xclusion was delivered to the person named at the top of this Notice at the date and time sIx:Pwn above b,y�; <br />Z , <br />......... ... . - ---- <br />(Signature o. person issuirq_�,d)fivering no6ce) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />-i - - - ------ -- <br />(Signature ol"person being issued the noticic) <br />),Vh�c, Copy Puhli.c Works C]Reon Copy", FiN, YeAkudy Copy. Report Copy Pink Cquy. R�fx,spoent CkAd (.r,,,P,, CMin:v Appv.,Anoficr. Rev. 04/03 <br />