1, <br />q NOTICE OF RESTRICTION OF USE Le 5L� <br />and Notice of Right to Appeal <br />D AT F TIME, CASE #: <br />.............................. . ............................... --- --------- ......... <br />LOCATION (.PARK, OPEN SPACE:),: <br />Nara : Last ]Fiat Middle D013: Race/scv <br />Res, Ad City State Zip Res. Phonc! Work Plione: <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 prohibited from (check box). <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />. ........................................... . . . .............................. . . .............. . .......................................... . ............................ ...... . .... -- . . .............. . ... --- .. ... .. ..................... .. . . . . <br />The basis for this Notice of Restriction of I Jse is that on j <br />you vioWed Section <br />!)f the Park <br />Open Space Rules, and/or Section , of the Eugene Code, 197 1, and/or 0 RS yoiu�� <br />(Description of the violation.) <br />This restriction of use is effective beginning on NO and shall remain in effect until 10-7 a <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 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. riecrte,'.."t, fin'.. an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division ENrector ("theDivision Director—) <br />within 48 hours (exclusive of weekends) ofreceipt 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 inforinal hearing to be conducted, which shall be not more than <br />'72 hours (exclusive of weekends) of receipt ofthe request for hearing, At the informal hearing the Division Directi,,)r Mll only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other wjttiesstsli('� thie, <br />incident. The Divisiox.i.Director may exclude anyone, other than you and ffiose presenting testimony, fi-orn the infbrrnal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />"Phis. Notice of Exclusion was delivered to the person named at the top of this N, ' c at the dale and. time sho%n alto vie by: <br />... ..... . ..... <br />(Sio ature of"person issuing/defivering notice,), <br />—3ix, <br />I hereby acknowledge receipt of the above Notice on the (late and time indicated above- <br />....... .... <br />(,Signature of person being issued the notice) <br />py: He, Yefflaw Copy! Repoh Copy pink Copy! ko,:jpjCWbL Guld ( opy � 0 M Q �� A pp�,H. I n o r: Kr10211AK, <br />M �e py� Publk,-. Works/ Curklr, I. <br />