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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIMLCASE # <br />L-2— ---.1.1-1.1.11 ­­ -11.1 .............................. . .......... I <br />1-,O('ATION(PARK/OPENSPA('1�,'),�:__ <br />I <br />op, <br />....... ....... . <br />Naufre: L,ast First Middle F)013: RacvScx: <br />. . . .............. . . . ................................................... . ......... <br />Res, Address: city Stat, Zip Res, Phwie�: Worle, Pfionc� <br />Under the authority (if Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are heireby <br />notified that you are prohibited from (check. box): <br />5a Entering in or using all City of Eugene parks, open spaces or facilities, <br />1100 ___11 <br />The basis �for this Notice of Restriction of Use is that on You Violated Section of the Park. <br />and Open Space Mules, es, and/or Section U� of the Eugene Code, 197 1, and/or 0 R S Tol wit, <br />.............. I ..................... <br />oi <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect unfill <br />www_........___. <br />If you enter in or use any City of Eu enc park, open space or facility during the effective period of this Notice, you may ble <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 an informal hearing to contest this Notice, Arequest fi.),ran <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Dire ctt,,)r") <br />within 48 hmirs (exclusive of weekends) of receipt of this Notice at the flollowingaddress: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a titne and place for the informal hearing to be conduc.ted., which shall be not ntore tharl <br />72 hours (exc I usive of'weekends) of receipt of the request f6r hearing. At the informal hearing the Di v i siorr Director wi I I only <br />consider testimony from you., City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other 1:hantyou and those presenting testimony, from the inf6mrial hicaring. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of 1. xclusion was delivered to the person narned at the top of this Notice at the date and time shown abovir Iby <br />T. ......................... . . ...... i . ........ N .................... ................. . . . . . .. ..... . ... .. .. <br />(Signature of person irssuing/defivering notice) 11 <br />hi <br />I hereby acknowledge receipt of the above Notice (in the date and time indicated above, <br />< <br />.... .. 7 .. . ....... . ..... .. <br />nature of person being, issued the ricm`,ic) <br />A%lc Cojpy: Public Work,� Cpn.mm C�rr)py: He Yellow Copy: RePOT1 COPY Pink (..'opyRecipiena� Odd (2opy Officer Apj[wr.0 noficr R e v . 04Ir,) 3 <br />