NOTICE OF REST RKTION OF USE NCO <br />and Notice of Right to Appeal <br />DATE": TIME: CASE <br />LOCATION (PA RK/O PEN' SPikC E) <br />Name: Last First Middle DOB: RaceScx: <br />0 OWL— <br />D6 pv-) <br />Rc,,,,. Address: City State Zip IRes. Phone: Work Ylhone: <br />Under the authority of"Adininistrative 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 />)SZ� Entering in or using all City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction of Use is that on iA , yu/ �11 oviolated Section ".. ro " of <br />o --tbe Park <br />j���D <br />and Open Space Rules, and/or Section ��l C J of the Eugene Code, 197 1, an ikox'ORS . . .. . ...... , To wit, you�:____L2�_CR-4 <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect unfl] <br />N V118 .... ....... <br />Ifyou enter in or use array City of'Eugene park, open space or facility during the effective period of" this Notice, y1ou may lble <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 inflormal 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 receipt of this Notice at the following uddress: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />'rhe Division Director shall schedule a time and place for the informal hearing to, be conducted, which shall be not more th'an <br />72 hours (exclusive of weekends') of receipt of the request for hearing. At the informal hearing the Division Director w 0 willy <br />consider testimony frorn you, City personnel involved in the incident that resulted in this Notice., and other witnesses tun the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, If iom the infim-nal heaxing,, <br />This Notice shall remain in effect pending any requested hearing. <br />Notice the da <br />This Notice of'Exclusion. was delivered to the person. named at the top of this at & and tirne shown above- Iby: <br />(Signature of person. issuing/delivering nofice), <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />- - - - - . ................_. <br />(Signature (if" person being Lssued the notice) <br />Mlne o...upy: Public'. Works r5reen Co pyo Fig o. Ycflow CopyR�,-port Or)py Pink CopRecipiew Gohrf Orficer AppeaP nc6r.v K04A) I <br />... .... . ........ -- .. . . . .................. . ......... . .. <br />