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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />wµ <br />DA,rE, TIM L: CASE 4� <br />. . ...................... . . . . . ............... . . . ......... . . . . . . . . . ... . .................. . . . <br />"I ) � .............. . . . - — - ------- <br />L.00AT'10N (PARKJOPEN SRAC E <br />Nanic. Last First MiddIc )CpW "ac�,", M <br />J <br />Res, Addre!is: City ,4ate Zip Res, Phone: W(Irk T'llone, <br />Itate <br />.... . .................. <br />Under the authority of Administrative Order No. 58-03-24-Fand Park and Open Space Rule R. -I 005(3), you are If <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />............ .. . ....................................................................... . .... . . . . .. .......................................... . .. . ............................... ...... . . . . . . <br />X <br />The basis for this Notice of'Restniction ofUse is that on yot,i violated Seetk�:Vn�� of thic Flark <br />rrr .. .......... . . .... ......... . <br />and Open Space Rules, and., or Slection . __ . of the Eugene Code, 197 L, and/or ORS � 'To wit, you _ <br />(Description of the violationj <br />This restriction of use is effective beginning on and shall renikain in effect until <br />.... . ................ . ...... ....... .. .. . ....... <br />If you enter in or use any City of Eugene park-, open space or facility during the effective period of this Notice, YOU wrivay ble <br />arrested and charged with criminal trespass in the secon(] degree. <br />Pursuant to Park and Open Space Rule R-1,074 you are entitled toan infbi-irial hearing to contest this Notice. A riequd,s.a, fror an <br />infornial hearing r.n.ust be rnade in writing and filed with the Parks & Open Space Division Director ("'the Division Director") <br />within 48 hours (exclusive c4 weekends) of receipt of this Notice at the following address1, 820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the infiorrnal hearing to be conducted, which shalI be not arwre than <br />72 hours (exclusive ol'weckends) of receipt of the reqUCSt f'Or hearing. At the informal hearing the Division Dircetor will only <br />consider testimony ftwu you, ( .'ity personnel involved in the incident that resulted in this Nol ' ice, and offier witnesses to the <br />incident. 'The Division Director may excltide anyone., other than you and those Presenting testi n -i oriy, ftoirn thie informal h ca ring <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 the date and time shown �,ibovir <br />. . . ................... . .. ...... <br />(Signature of'persion ig�si[.iiinfdiv <br />Hviering notice,) <br />IffIs� t1 <br />A4, <br />I hereby acknowledge receipt of the above Notice on the data: and tirne ilncficaied above. <br />(Sigzfature oVperson being issued the mxicic,) <br />WhItu Copy: Public Vlork.q, Grcen Copy HcYr.Alow ®r)py',Repoft Copy Pink Copy.Kpcipi�,mt G'6d Cujjpy: (.)Mcc,r ApjrveM nulkx . IrW rl'):r <br />