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NOTICE OF RES'FRICTION OF USE <br />and Notice of Right to Appeal <br />DATE. TIME: 7 CASE # <br />LOCATION (PARK/OPEN SPA <br />i7l� A LIP, 0m. W <br />. ................. a­�h�, - All <br />N HTst Middle DOBi Race/� q,X- <br />Res, Addra !!C)tv State yup.. Phone� Work rlhww: <br />" <br />tN Al E eA <br />U nder the autho rity of Admi nistra tive Order No. 58 -03 -24 -Fa nd Park and Open Spa cc Rule R-1.005( ), you are ha reby <br />notified that you are prohibited from (check box): <br />400, Entering in or using all City of Eugene parks, operas a€°es or facilities. <br />. . ......... . �� .. ............................ --- ..................... .. ... . <br />The basis for this Notice olf'Restriction of Use is that on <br />you violated Section <br />..... ..... <br />and Open Space Rules, and/or SeCtion 010 of the Eugene Code, 1971, andlor ORTo wit, you .. . . . . .............. <br />'e. -r, . ........................................................................................................ <br />(Description of the violation.) <br />This restriction of use is effective beginning on ?�� B a nd .bill, rema in in effect u Will —0.7—, z 1.5 <br />IF you enter in or use any ("ity of.E, ugene park, open space or facility during the effective peric)d of this Niotice, you may be <br />anvsted and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R-1,074 you are entitled to an lnk)rmal hearing to contest this Notice, Arequestf'orafar <br />informal hcar-ing must be made in writing and filed with the Parks & Open Space Division Director ("the <br />within 49 hours (exclusive ofwcekends,) of receipt ofthis Notice at the follow ingaddress : 1820 Roosevelt, Blvd., Eugene,, OR. <br />97402. <br />The Division Direuor shall schedule as time and place for the informal hearing to be conducted, which shall be not narne than <br />72 hours 4exclusive enl"wa:e:kendst of receipt ofthe reqUeSt for hearing. At the informal hearingthud Divi ion Director will only <br />consider testimony from you, ('1.,,'i[y personnel involved in the incident that resulted in this Notice, and other vvitnes,�,.;es tio the. <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, frDIU the' inf6lTnal hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of'ExclU%ion was delivered to the person. nimed at the top ofthis Notice at the date and firne shovin ablowie by� <br />. . . .. ............ . ........................... . ................ <br />(Signiature ofpierson notiice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />..... . . .. .. . . ............. - . . . ..... I .................................................... . . . . . . . <br />(Signature, of 1,>ersoln being isslued the: nioficier,'p <br />Wh ii I c Copy P Ai c Woflas Green Copy: Filk, Y el I ow iC ap y: Rcrxil rT. d,: opy P'in'k Cop(A d Cany, D ficer A p pz- g[Il nuil i v ,, R1. r -v l <br />