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NOTICE OF RESTRIC'VION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: CASF� 0: 3 <br />. ................................ . . ....... ... . . .................. .. ....... . . . . . ......................... D ....... . . . ..... 9 <br />.......... <br />L0(1'ATl()N (l1ARK/0PJFN SPACE) . . .......... <br />tsaMe awt First Middle D013- R ace. <br />z <br />CSS� Zip Res. Phone: Work Phone� <br />Res, Ad <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 />notified that you are prohibited from (check box): <br />Entering in or using all City of E'ugene parks, open spaces or facilities. <br />The Basi J� , C) t (".") ( (a I <br />a 0-C Y4)U Violate( -i S�"-"or' 1�1&rk <br />s for this Notice of'Restriction of Use t <br />is h, t, on <br />and Open Space Rules, andlor Seetion't). C�Q)-of the Eugene Code., t97t, and/or ORS <br />- . ........ ................ <br />(Description of the Teri ation.) 6 F r <br />To wit, Yow--.- <br />-Vj Lc-�-t <br />C��, C�. C- ?a G ( � <br />This restriction of use is effective beginning on nd shall remain in effect until ( <br />. . ............ . .. .... . . ................ . ......................... .. . . . . . . . <br />If you enter in or use any City of Eugene park, open space or facility during the effective peTiod of thi,,, Noti(,:ic, you ruay be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park, and Open Space Rule R-1.074 you arc cntitled to an informal hearing to contest this Notice. A request fior an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Dire,L::'lnr-) <br />within 48 11OUrs (exclusive of weekends g of'receipt of this Notice atthe following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place fbr the informal hearing to be conducted., which shall be not niorr than <br />72 hours (exclusive of weekends) of'receipt of the request for hearing. At the inftirmal hearing the Division Director w0I only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice., and other wiinicyws lo the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, Ii om. the in1r6rinai hearing, <br />This Notice shall remain in of pending any requested hearing. <br />This Notice of Exclusion was delivered to the person nanied at the top o6'thi5s N )t] —at t.he dateand time shown above by: <br />D <br />. ............ . . . . . . .............. -- <br />( <br />-(S igna ture olf person Lssui ng/idel i veri ng w)t i u c) <br />I hereby acknowledge receipt sill the above Notice on the date and firne indicated above. <br />- TZ <br />at tj r, c <br />o) personbeiff"g', issued the nolicel <br />While C opv IPikkbh,,: Work�';rc:r.n Copy: Fk. Yu Row Copy 4 P.- por� Copy Pmk Cup y: Recipicinf. G ol d r,:'o py: i4 ur"l cer A pp ea I in o t i or Hua04/03 <br />