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0 <br />NOTICE OF RESTRic-riON OF tISE <br />and Notice of Right to Appeal <br />DATE:FINIL . . ............ . . . . ........... <br />I-OCATION (PAR OPEN SIIA,Cfl� Mo,,A�,t Srt-, Ile <br />. ..... . . . . ................. . . . . . ..... ji A—.1 11 ............... . . . . ........... .. ............. . . ...... . . . . .. . ........... - ----- . .. ............ <br />...................... <br />Marne: Lagi First Middle DOB� Rice/Se <br />E� <br />� .4 , c)ee3 #'A <br />�`AAtL 21 <br />Res. Address; 'City State Zip Res. I'huneWork Phone:� <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 />. . ....................................... —..— _m.... WW. . . ...... .. ... .. . .................... . . ...... -.- . ........ . <br />The basis (or this Notice of'Restriction of(Ise is that on 4404ir you 11 vkjdated,rSection .011101 NNI P1 -k o, the ar <br />and Open Space Rates, and/or Sectilon OP Of the Eugene Code, 197 1, and/or ORS ...................... Tc)i NNit" you: ... . . . .................... <br />'2/--rK 14%j <br />( . . . ... . ...................... ............ . . ............. . ......... <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until W* <br />If you enter in or use auny City of Eugene park, open space or Cacility during the effective period oCthis, 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 art informal 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 Directc)r ('-'the Divisicn.i Director") <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following address:: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Direcioir shall schedule a time and place for the intlorma] hearing to be conducted, which shall be not inore than <br />72 hours (exclusive of weekends) oaf receipt ofthe request for hearing. At the infonnal hearing the Division Director will only <br />consider testimony frown you, City personnel involved in the incident that resulted in this Notice, and other witnesses to thit.- <br />incident. The Division Director maay exclade anyone, other than you and those presenting testimony, from the informal hiearing, <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 above by: <br />(Sigivature orperson i^'.','suing/dehvering rilofice) <br />I hereby acknowledge receipt of the above Notice on the date arid tinie indicated above, <br />(Signatare of'person being issucil the noticiel <br />Who Copy, rlubhc W06vi Grevmn Copv� Fdu Vellow Cop,,v: Repon Copy Pink Copy: Recipiew GfAd Copy! OfR:c-i Apr al Rcv, 04' , 03 <br />