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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIIME� <br />DATE: CASE #: <br />. . ......... .. ----- --.................. .......................................... <br />I...,C)CATION (PARKAVEN SPA,(, NPI� <br />. . ............ . . . . .......... . .................................................. . <br />Nzane: LastLMiddle <br />Av, <br />KL� <br />k :Ta47 <br />(I <br />Reg. Address• City State Zip Re, Phoneo- <br />Linder 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 />The basis for t1ris Notice of'Restriction of Use is that on you violated Seclion th V P ".11. 1"', <br />Z -1, J. C) �t <br />................... . ............... . <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or OR.S To Wit, You: .................................. . <br />LT-x� <br />- - - ....... - <br />(Description of the vialation.) TJJ16 0 ,, r <br />F[ <br />This restriction of . . . use is effective beginng o <br />nin L . . . . ...................................... 4"1 <br />212--L.5 1i and shall remain in effect until 0 ........ <br />1'r" ­` 2 <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Notice, You rnay be <br />arrested and charged with cnininal 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. A request for all <br />informal hearin.g must bc made in writing and filed with the Parks & Open Space Division Director ("the Division Director-) <br />within 48 hours (exclusive of weekends') ofreccipt ofthis Notice Qat the following address: 1820 Roosevelt, lvd®, Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inl'ortnal hearing to be conducted, which shall be not mcwe than <br />72 hours (exclusive ol'weekendq) of receipt of the request for hea'iring. At the 1rifonnal hearing the Division Director will m4y <br />consider testimony fir(All You, City personnel involved in the incident that resulted in this Notice, and other witniessi-s to, this <br />incident. The Division Director may exe lude anyone, other than you and those pr senting testirnony, from tine i n IOrTnal hearing. <br />This Notice shall remain in effect pending any requested bearing. <br />This Notice of Exclusion �vas delivered to the per -son named at the top of this Noti -, the Ckde anc U i , shown above- by- <br />. . . ........ . ............................. . . . . . . <br />0 , i . ... ........ i ut fwrst In is iig/clelivering nofick"), <br />,na <br />l hereby ackriowledgc receipt of the above Notice on the date and time indicated above, <br />........................ <br />(Signature of person being issued the no6cc) <br />`MulCopy Pubhr Works (herm ('opy: E,&Yeflcmv CupyRi.,.port Pura. C'opRc6picm6ulld Cojpy: Offica AvpeM noilicve fav v- 04/01 <br />