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NOTICE OF RES]"RIre" ION OF USE S\A5 6A <br />and Nofi,e 1 Ri lit to Appeal <br />Z, <br />DATE: I IMF� CASE #: <br />. ................... ..... ............................ ....... .. . . . . . <br />UX " AT -ION (PARKIOPEN SPACE)� <br />.. ... . ......................................... <br />Naine: Last <br />Res,, Address� <br />j 41, rstMiddle I DOB, ➢, facell X" I <br />ERMnm- Bfej6,-T-r oqao 7Y Al <br />Res. 11horw: <br />airy State I Zip Work Phone�: <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R4.005(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 />. . . . .................................................... . .. . ... . . . . . . . .......................... . <br />The basis for this Notice of Restriction of Use is that on. you violated Section ofilic Park <br />-0 lt-&- ............................ . .... .. . . . . .......... . ..................... <br />and den Space Rules, and/or Section q, . ......... . ............ . . . . . .. ...... __ of the Eugene Code, 1971., andJm- ORS . ... . .... ... . 'To wit, you . ................ <br />(Descriptiam of the violation,,,) <br />This restriction of use is effective beginning on —.1 and shall remain in effect until <br />............. <br />IfYOU enter in or use any City of_" Eugene park, open space or facility during the effective peiiod of this Notice, you may be <br />arrested and charged. with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule p-1.074 you are entitled to an informal hearing to contest this Notice, A roquest f6t, ,arj <br />informal hearing niust be made in writing and filed with the Parks & Open Space Division Director ("the Division I)irriclor") <br />within 48 hours (CXCILISiVC of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd, Eugene, Olt <br />97402. <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the infonnal hearing the Division Director %vW only, <br />consider testimony from you, Cstye personnel involved. in the incident that resialted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, kom the infbrinal hearnig, <br />This Notice shall rernain in effect pending any requested hearing. <br />This Notice of'Fxclusion was delivered to the person named at the top of this Nig tt the (late aand time show, above by: <br />. . ........ I ................... . n - - - ---------- <br />(Signat c of person <br />I hereby acknowledge receipt of"the above Notice on the date and time indicated above. <br />eat person ing msued the nwicc) <br />Whkt CcqsyPubfic Works GreenCopy Fih,-. ydlkw; (.'OpyRenpowl Copy Pink CorovRixApirnw C0114,f CUJJY, 0MICF,'T A�)J.)PaYH.Ak-z' Re0-U "B <br />