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C <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE- <br />TLM E: CASF <br />......................... . ..... . . . . . . . ....... . . ..... . .. . ............. .... . . ... .. . ........................... . . - - - - ------------- 47 <br />LM.'A"HON (PARK/OPEN SPACE) �� .......... . ...... . . . . ........................... . . . . .. .............................. . . . . . . .. ................. <br />Naivca LkslPi T"t <br />Middle DOW Rue',`Scx� <br />Res. AddrossC Nh . Phone� Work Phone: <br />zip7S <br />, <br />2-60 34S RZC,,-r C <br />Under the authority of Administrativ e Order No. 58-03-24-F and Park and Open, Space Rule R-1,00 (3), you are here by <br />notified that you are prohibited from (check box): <br />Entering in or nsingoll City of Eugene parks, open spaces or facilities, <br />kik <br />0 .­­ . . . ............. ­ . ............................................................. . ..... . . . . . ....................... . . ........... . . . . . . ........................ ................................ . . ... .­ . . ..... <br />The basis f'or this <br />1 N oti cc t) f Restri ction f tise is 0 4:,, 2, ykn, violate(, Secli,)YI �O/ <br />the Park <br />06 — --------- <br />and Open Space Rules, and/or Section f the.Eugene C'ode, 1,97 t, an(Vor ORS "1 cu wit, You � . ...... . <br />. . <br />004"''14AII .5.5 <br />. .............. . . . ............ ............. <br />(Description of the violation,) <br />This restriction of use is effective beginning on7/ /g - <br />and shall remain in effect until <br />.......... <br />I f you enter in or use any City of Eugene park-, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the see(.-Prid degree. <br />Pursuant to Park and Open Space Ruic It -1.074 you are entitled to an informal hearing to contest this Nc,)tice. Ariecjuic-,,ytforan <br />infornial hearing inust be niade in writing and filed with the Parks & Open Space Division Director (""the (_Division. Director"") <br />within 49 hours (exclusive ofw%eckcnds) of receipt ofthis Notice at the following address: 1821) Roosevelt, Blvd., ugene, OR <br />97402. <br />The Division Director shall schedule as time and place ft.)r the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive ofweekends) of reeelpt. orthe request for hearing. At the informal hearing the Division Director wiH only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to 1hic <br />incident. The E) ivi si on Director inay exc lude anyone., other than you and those presenting testirnony, from t h e inforryial heari <br />This Notive shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the per -son named at the top of this Notice at the (late and t shown abovie by: <br />ictLL <br />(Signaturc ofpers�an issuing/dehIveeril <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Signature alperson being issuccl the noticie) <br />WhAe C.Opy, PIMk' Workr Green (.'opy: H": Y ¢11ow iC op y: Report Copy PaO4 r,.'apy: Recipinnp G'rAd Cf.-.Rpy: Diffircir Appcal nofior� V.F.T, LW03 <br />