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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE:: TI.ME� <br />CASE fi' <br />. . ............ . ... <br />LOCATION (PAR OPE SFACE):� . . ..... I . . . ................ . . . . .............. . ..... . ",Kwrz <br />NaTne: L I ast First Middle rxm-) Race/Sex: <br />ly <br />Rea , AddremCity Slate Zip Ikes, 111-ione�: Wor$c Plionle: <br />tinder 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 Eugene parks, open spaces or facilities. <br />. . . . . .......... . .. ..... . . - . . . ... . . ...... . ..... . . . . . ...... . ................ <br />The basis for this Notice of'Restriction of Use is that onyou vio hited Section oi (Y <br />Park <br />and Open Space RWes, and/or Section ... Q 0 o f the Eugene Code, 1971, and/or ORS "'fen wit, you. <br />A <br />........ . ...... . IWV11 . ..... . . . .......... . ........... . . . . . . . . . . . . ............................... .... . . . ........ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until _— ----- <br />1-f you enter in or use any Clity of Eugene park, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with cdrninal trespass in the second degree,, <br />Pursuant to Park and Open Space Rule R-4.074 you are entitled toan informal hearing to contest this Notice. A request fi.pr all <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Directc)r ("the Division Dimr,!tol") <br />within 49 flours (exclusive of weekends) ofrcceipt ol'thl,,,, Notice at the following address: 1820 Roosevelt, Blvd., Eugene, ()R <br />97402. <br />The Division Director shall schedule a. time and place for the informal. hearing to be conducted, which shall be not iffian <br />72 hours (exclusive of weekends) of'receipt of the request for ht.-,aring. At the in rornial hearing the Division DireTtor wffl only <br />consider testimony from you, ( lity personnel involved in the incident that resuitcd. in this Notice, and otherwilricsses to the <br />i <br />incident. "I"he Division Director may exclude anyone, other than you and those presenting testirnoi a From the fid'ortnal hcaxirng. �y <br />This Notice shall remain in effcvt pending any requested hearing. <br />This M-lifice of'Exclusion was delivered to the person narried at the top <)['this�,14otice at ffioiiitk. and t shown abowe Iby� <br />(SipriZIMIre ofoer.son issuing/idelivering nofice) <br />I hereby acknoMed,('!c receipt of Asha~ above Notice on the date and trine indicated above, <br />(Sng,naturecif'plerson being issued khe <br />While Cipjjv,'! Pubhc Work,,> C'up,,: Fflu Y""How (Alpy, Repon (:,opy Pink Copyfkpcp�en� Gokw CojjpyOtyimcir Arpead ml-�6c'e Rrwo-V03 <br />