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NOTICE OF RES'l"RICTION OF USE <br />and Notice of Right to Appeal <br />DATE. ........... 4— <br />................. . ...... . TIME: CASE ftv: 1,5 <br />I-OCATION (PARKJOPF"N SPAC'E)� <br />.............. <br />Name� J -aa First Middtc DOW Rjce/Sev <br />m. <br />7/ <br />U., <br />. .................. <br />Res, AddressCity State Zip ltes- 11111ollc: Work Phone:: <br />Under the authority orAdministrative Order No. 58-03-24-Fand Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />X <br />The basis for this Notice of Restriction ofU se is that on you violated Section1, 10/0t)�)ofthe Park <br />...... . . . ................... <br />and Open Space Rules, and/or Section of the Eugene Code, f971, and/or ORS . . . . . ......... ... T'o wit, yc)u. <br />5'ry"ok,j & --L - �,g- , L ........... =2 7 <br />L ___ 1..tt. . ........... . ............................................. <br />(Descriptir,m of the violation.) <br />Phis ro-triction of use is effective beginning on and shall rernain in effect until ............. . q <br />1[L1q115---- ?&...i . ...... . . <br />If you enter in or use any City of'Eugene park, open space or f�cility during the eff ctive period ofthir.�a Notice, ycn.i n -)ay l.)e <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 inkirrnzil hearing to contest this Notice, A requiest [br an <br />int'on-nal hearing must be madc in writing and filed with the Parks & Open Space Division Director (""the Division Diriector") <br />within 48 hours (exclusive ot'weckends)cif receipt of this, Notice at the following address,: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a firm. and place for the informal hearing to be conducted, which shall bee snot rritore than <br />72 hours (exclusive of weekends) of receipt of the rcquest for hearing. At the in ronnal hearing the Nvision Director v,,ill only <br />considu- testimony ftom you, City personnel involved in the incident that resulted in this otree, and other Yvifiriesses to 'tiv-. <br />incident. The Division Diricctcw inay exclude anyone., other than you and those presenting testrrru.my, from the inforrnaI hearing, <br />This Notice shall rernain in effect pending any requested hearing, <br />This Notice of Excl-usion was delivered to the persc.)n named al. the top ofthis Notice at the date and time shown above by: <br />..... . . . .... :6 S ............... . ............................. <br />Signaturc of P'erson, isskjingi <br />c e rVertrig notic%".) <br />I hereby acknowledge receipt of the above Notice on the data; and time indicated above. <br />..... . .... oz—o ... ... .......................................................... . ............... . .. .... .. . <br />(Sig,nature of jpier,,on being issued the nccel <br />Wuw iCopy. Public Work, Gicen 1(7,opy: File Ydlow CopyFic-prmt Copy Pink Cqry RcOpk-w (Jolid Ccrpy;.of-fic'er Appeal RILAOf" <br />.......... <br />ifflogNEW <br />