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NO'I'ICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE� TIME: c Z-1 (-'ASE
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<br />. ................................. ................. . . .. - --- - ---. . .......................... ....... . . .
<br />L,OCATION (PARK/OPEN SPACEr IrK1111 ^j
<br />Name� Last First Middle DOR Raccex
<br />/s'
<br />I '�iL4 -h-7
<br />. A'Jas
<br />Res. Addrew City Statc Zip Res, Phone: Work Phonc�
<br />111111P
<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 1probibited from (check box):
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />W
<br />11
<br />lat on you violated Section t"01
<br />The basis for this Notice of R(..�,striction, of I Jse is d 0 1- Pair ke.
<br />and Open Space Rules. and/or Section -). (nli ..... . ...... -,- of the Eugene (,."(-,)de, 1971, and/or OR.S TO, WiL,Y1(PU:______
<br />.................. ..... . .......... e. !� . ............................................. . . . . . ........... - --------
<br />.............. .
<br />(Description ofthe viuflatlon.)
<br />This restriction of ub
<br />se is effective eginning on and shall remain ean in
<br />ieffu
<br />ect ntil,
<br />4-w-� . --il 1 .' .............
<br />11' you enter in oar rise any 1ty of Eugene park., open space or facility during the effective periud (if this you, may be
<br />arrested and charged with criminal trespass in the second degree,
<br />Pursuant to Park and Open Spacc Rule R-1.074 you are entitled to an informal hearing to contest this Notice. Arequiestfi)reuro
<br />inforn-tal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division.Dirtckrr"p
<br />within 48 hours (exclusivc of weekends) of receipt ofthis, Notice at the followin.- K.1dress: 1820 Roosevelt, Blvd., Eugene, OR
<br />97402.
<br />'nie Division Director shall. ;chedide a time and place flor the ink)rmal hearing to be conducted, which shall be not more ffi,,an
<br />72 hours (exclusive of weekend.s ' ) Of receipt of the request for hearing. At the in fbrtnal hearing the Div ision Direct tor Y,, i IN an ly
<br />c(..)nsider testimony trom you, (, I ity personnel involved in the irwident that resulted in this Notice, and od'ver witnesses to Ute
<br />incident, The� [)Msion Director nray exclude anyone, other than you and those presenting teq1imony, fforn the infiornial hicaring,
<br />This Notice shall remain in effect pending any requested hearing.
<br />This Notice- of'Exclusion was delivered to the person named at the top of this Notice at � datc and tirne shown abovic t),y:
<br />IC
<br />(Signatirre ofpci-son vr,,,,sunig'
<br />t hereby acknowc(Jgc receipt ofthe above Notico on the date and time indicate(J above.
<br />(Signaturic of'person bieing!11,s,Nued the rilotioe)
<br />While Copy: Pivhlb: Wod"s Grevin 'Coply: 'i� e I n wm iC oV.y � RepoTt C L �py N3 � k. C o p y ! R ecr, i V m i I GAI d Golp y ; C), n I !,,,, R, A I ri uil i ,, i,, ]Wrr'. u V , 11 M�i � l�
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