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\0wom Q1( <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Riuht to Anneal <br />J <br />DATF� TIML CASE ZI <br />. . ........................................... . . . ......................................... . ......... . . ... . . ....... ............... . <br />. ... ............ . ............. . <br />I .0CATION (PA,RK/0PFN`mr <br />Name� L.a.q <br />z <br />Res, AddTCSS: <br />Md N I V"' <br />lw� <br />Firl Middle <br />ni'y I State Zip <br />D�)B [Yce"Sc- <br />Res. 1111011c:: Work, 1'16ne <br />Under the authority of Administrative Order No. 58-03-24-Fabed Park and Open Space Rule R-1.,005(3), you are hereby <br />notified that you are prohibited from (check box): <br />49' 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 ------------------- �of the Park <br />and Open Space Rules, and/or Section) of the ELIgCne Code, 1,971, and/or 0R.S 0 wil, yimr: <br />-'q(t') <br />.... ... ..................................................... "e . .......................... . . . ..... . . <br />(Description of the violation,') <br />� <br />li U-1 and shall remain in effect until <br />This restriction of uon qqse is effective be ........................ ................... . . <br />ft'you enter in or use any City ofEugenc park, open space or laicly during the effective period 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 R-1.074 you are entitled to all informal hearing to contest this Notice. A request ffir an <br />infori-nal hearing rriust be made in writing and filed with the Parks & Open Space Division Director. (" the Division Director") <br />within 48 hours (exc I usi ve of weekends) of receipt of this Notice at the fol llowing address a 1820 Roosevelt, Bl vdu, Eu ene, 0 R <br />97402. <br />The Division Director- shall schedule a time and place f6r the inf6rYnal hearing to be cifniducted, which shall -br not more lharl <br />72 hours (exclusive of weekends) of receipt of the reqUeSt for hearing. At the informal hearing theDivision Director wiH only <br />consider testimony frorn you, City personnel involved in the incident that resulted in this Notice, and other witnesses to thile <br />incident. The Division Director may exclude anyone, other than you and those presenting testirnony, from the infornial hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named kit the top ofthis Notice at the dart, and tirne shown above [:,ay! <br />. . . . . ............. . .. ��, � �� :11 <br />--------------- <br />(S igVi atulre ofF.wrson issuing/defivering n0tilvil") <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />�A <br />(Si nature ol'pers, <br />n lac' S" L <br />I Ismill L� -ig ssued the nod <br />I <br />white ropy: Pubfic Wcmlks Filc Yd pvw Ciropy: Rupro rl Ci Rpy Pink Cup; i Reciplvti�( kyki Cropy: OffirXF AppuaC nudr,',c, R,evK'03 <br />