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NOTICE OF RESTRICTION OF USE <br />and Notice or Right to Appeal <br />`7 <br />DATE: TIML <br />(01� Ir + <br />LOCATION (PARK/OPFN SPACE),' - <br />.................. - ------ .................................... . . .. .................................................... ---------------------- <br />Nanie- t FMicidle DO,B. <br />l, C, k4 irst <br />e <br />LVE. . . ............................ <br />Res. Address, Clity rate Zip Res, Phone: Work. Phurie� <br />(0 <br />Under the authority of Administrative Order No. 58-03-24-Fand Park and Open Space Rule R-1.005(3), you are hereby <br />motif ed that you are probibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />... ......................................................................... . . .......... <br />The basisfor this Notice of Restriction of Use is that oilyou violated Section, of the Park, <br />. ..... ..... --------- . . . ............. . __ <br />a5wnd Open. Space Rules, arid/or Section of the Eu gene Code, t 97 t, ancUor ORS i'11X, 'ro it., y0k,E <br />,.__....I ............ C........................ <br />.. . ........... . ............ . I .... tz <br />(Description or the violation.) <br />11,3 <br />This restriction of use is effective beginning on and shall remain in effect until, ir, 7 <br />If you enter in or use any City of Eugene park, open space or facility during the of ertive period. of this Notice., you rn,,.ty be <br />arrested and charged with criminal trespass in the secq,,)nd degree. <br />Pursuant to Park and Open Space Rule R 1.074 you are entitled to an informal hearing to contest this Notice. A reqUcSl for an <br />infor-nial hearing inust be rnade in writing and filed with the Parks & Open Space Division Director (" the .I.Nvision Director") <br />%vithin 48 hours (exclusive of weekends) of receipt 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 in fortnal heariTIg to be conducted, which shall be riot snore,than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testiniony frorn your, personnel involved in the inci(Jent that resulted in this Notice, arid other witnesses to ffic <br />incident. The Division Director may exclude: anyone, other than you and those presenting tcstirnony, from the inform al. hearing. <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 dame; and tinie shown above by: <br />........................................ ......... <br />(Signa lure of person issu ng/del i qering notic"e) <br />I hereby acknowledge receipt of the above Notice on the date and firne indicated above. <br />1A- 4 .tent , <br />F, t �( - - I (_ "I ....................... <br />................... �r .............. . 2 U-6- , �, <br />(Signature of'person 'toeing j,,s6iued the notice.) <br />WMte (.'opy. Pubfic Wc)rkt� Greem(!Opyl Flh-. NCNINV Cllpy. TARP00, COPY Pink C'c.apy. Recipient Gord Cnpyl Oflwv Appea� nolice R".", 0410, <br />