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NOTICE OF RESTRK.-FION OF USE <br />and Notice of fight to Appeal <br />DA I'L-9 <br />TIME: 1,17 V1 ��VN I[ <br />. . .... CASE #! . ...... . ... . . . . . . ... ................................... . . . . .. .... .. .. ... <br />LOCATION (PARK/OPEN SPACE). <br />I —4--�-'a . . . ................ . . . . ....... . . ..................................... . ... . .............. .. . . . . . . . . . . . . . . <br />NRmLast First Middle D( B Race/s <br />�%11 SELI L <br />tit:;. Address: City State Zip ResPhcpne; 'Work 1pfione; <br />Under 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 (cl-iieck box')-. <br />1-ir Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 --- . ...... ............ . . . . . . . . . . . . .............................................................................. .... . .... ....... ......... . . .... <br />The basis for this Notice of'Restriction of'LJse is that on you violated Section of the Fark <br />and Open Space.Rules, and/or Section 1---QX0--.of'the Eugene Code, 1971, and/or YRS ........................ Towit, you:_..._. . .. .... <br />crm <br />(Description of the violation.) <br />This restriction of use is effective beginning an and shall remain in effect until <br />If you enter in or lase any City of Eugene park, open space or facility during the of period ofthis Notice, you rnay be <br />arrested and charged with criminal trespass in the secoind degree. <br />pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contest this Notice. A, request f6T an <br />inf6rinal hearing must be made in writing and filed with the, Parks & Open Space Division Director ("'the Divisdori Dirlector"') <br />within 48 hours (cxclusjva° ol'weekends) of receipt ofthis Notice at the t1ollowing address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a fix-rie and place for the informal hearing to be conducted, which shall be not miure duan <br />72 hours (exclusive ofweekends) of receipt of the request for hearing. At the informal hearing the F)ivision Dri-ector vidl 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 than you and those presenting testimony, ftorn the, infbirrnal hit-,aring, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and firne shown above by: <br />. . .. . .......... -�Z�z -------------- - - <br />(Signature rApet',son is"'suing/delivering nolfict.) <br />I hereby acknowledge receipt of the above Notice on the data: and fin -le indicated ubovc,, <br />to <br />------- <br />(Sig,nature of person beink, iss'acd the nobc,e) <br />White Copy Pubfic Works Green C.,opy: He Yr'. -flow Copy: Report C,opy Pink (.'ojv.r Recipie-nl (J DId Copy �0H i c eT A p pea I ncs.e Rev- [UPE,13 <br />