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D A TE: �O 6 )-e, I S-` <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIML CASE E 4 <br />LOCATION (PARKYOPENPACE......o.gjI <br />AL. . ........... . . --- - -------- . . . ....................... . .. . . ...................................... .. . . .................... .. .. . <br />Narae: Last First Middle DOB: R.ace,/Sexl, <br />ILI Req. Address,; City Stare Zip des. Phone- Work Hikinc� <br />c7" C- 0� 12_6 <br />.. . ....................... <br />Under the authority of Administrative Order No. 58-03-24-F and Vark and Open Space Rule 11-1.005(3), you are herebY <br />notified that you are probihited froni (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />............. ­ . . . .................................................... _­­ . . .... . .............................................. . . . ................. . . ...................... . ................. . . . ...... <br />The basis fir this Notice of Restriction of Use is that on 00-6#3' YOU violated Sek;fion LA 0 o F the Park <br />... . . . ........... . — I ......... . ................ . . <br />and Open Space Rules, arid/or Section ' ! � 40 - ofthe Eugen e Cod e., 197 1, andlor 0 R S ..... . ..................... . . . . . . -- <br />............----- 1� wit, YotL­____ <br />M V <br />.......................... . ................... . . <br />q...... ... !� ................................. . ...... . . . . . ............ . . . . . . . . . . . .. .............................. ..................... . . ......... <br />(Description of the violation.) <br />Thisi restriction, of use is effective beginning on OL �-6 l <br />and shall remain in effect until 0 <br />If" you. enter in or use any City of' Eu park, open space or fialuility during the effectivie Iulerio sof this Notice, you ri'lay Lie <br />arrested and. charged with criminal trespass in the second degree, <br />pursuant to Park in d Open Space Ru le Ft. -1.074 you are entitled to an in torn ial bearing to contest dais Notice. <br />informal bearing rnust be made in writing and filed with the Parks & Opwj Space Division Director ("the Division Director") <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice sit the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the infortual hearing to be conducted,, which sAiall 1,�e not more flian <br />7' .1 liiours (exclusive ofweekends) of receipt of the request for hearing. At the inf'ormal. hearing, the Division Director wfl] ainly <br />consider testiniony from you, City personnel involved in the incident that resulted in this Notice!., atul other witnesses to the <br />incident, The Divisiori Director may exclude anyone, other than.you and those presenting testimony, ftoin the irsforTTW hiearkig,. <br />'This Notice shall rentain in effect pending any requested hearing. <br />This Notice of'Excl usi o a was, de I ivered to the person narned at the top ofthis N06 cc at the date ti c shown above 1)y: <br />....... . ........ <br />LA <br />(Such trace r <br />I hereby acknowledge rii�.,,ccipt ofthe above Notice on the date and time indicated above. <br />. ................................ . ... ..... .. (111111(_,� . . . . . . .. ..................................................................... . . . <br />(Signature ofperson being issued the notice) <br />WhBW Cujjpy, pubhc worhs Gr"S) CopyHe Yel low Copy: Rupod. Ct)py Pink CopyRecipient G . Ad Cop y: Ofrk:er A V7 poa I R Nf u I i Qe pt4,0 I <br />