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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATEI - Cl ASE <br />- ------- . . .... . . ................ . . .... ------- S6 . . . ... ............... .... <br />LOCATION (PARK OPEN SPA <br />---------- <br />......... . . . ......................... . ..... . . .......................................... .. . . . . <br />1, i rs I Middle LN I )H� kace/Sex: <br />A <br />17D <br />Res, Addrcss� City Sta zip 1R.C.S. plione Wc,)lrk Hone: <br />— — - - - - --------------------------------------- <br />41f <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 Euge"e parks, open spaces or facilities. <br />. ................ . . . . . . .................... . . . . . . . . ... . .............. . ........................... . .. . <br />v D � (�-) <br />The ba <br />basis for this Notice (if Restriction of Use is that on you. vm1ated Section— (jf the I'arl< <br />. ......... . . .............................. <br />and Open Space Rules, and/or Simlion 96 . <br />. ... . ............ of the Eugene Code, 1.971., and./or ORS To wit, you . .. . . .............................. <br />R,01/2, <br />................ <br />(Dcscripuori ofthe violation.) <br />This restriction of use is effective beginning on r? and shall remain in effect until <br />. ..... ................. . . .. . ... . ... <br />VYOU enter in or use any City of Eugenc.park, open space or facility, during the effective period oif this Notice, ycnj mIy be <br />arrested and charged wifli criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1,074 you are entitled to an informal hearingto contest this Notice. Areqi,wstfor;rasa <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Dircclor, ("the Division Direictir.:)r-i <br />within 48 hours (exclusive of,weekends) of receipt ofthis Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the informal hearing to be conductcd, which shall be not mcntthan <br />72 hours (exclusivc of weickwid,%) of receipt of the re(..Iuest for hearing. At the informal he tering the Division Director will only <br />oonsider testimony from you, City personnel involved in the incident that resulted in this Notice, and other Mtnesst.^s to the <br />incidern. "l" he Division Director may cvclude anyone, other than you and those presenting tostirriony, fi-om the kikvrmal licaring. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice o C f-,,xc I usi on wars delivered to the person named at the top o (" this~~ Notice at the data, and time shol vm above by <br />.................. . ......... <br />-- -------- <br />(Signature of'person issuing t. e j vcring, nodiuc,) <br />I hereby acknowledge receipt of the above Notice on the elate and tirne indicated above. <br />16 <br />...................... . . . . . . . ------ . . . . .... ----- .... . ......... . .................................... . ... . I . ....... . <br />(Signature of person heiDg issued the noticie) <br />%klhhe C'cqry! Pubfic, OWurlo; Grecn Cspy: FAA Yr'llu"v Copykepkml� co�.'Jy Pmk iCopy!r ipuaPrt. (Y'old Copv� Officer Appeal nolicf.- IK,,:,, 04"03 <br />