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�, D <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to) Appeal <br />DATE� TI M E 0 j L -k CASE#� <br />LOCATION (I ARK SPACEj-,_ (,,,j... <br />I A*� a . . . . ............ ....... ..— ------------------------------ . ......................... . ................. . . . . . . . . . . .. ...................... .... <br />. . .................................. <br />Name� Last First1ex: <br />Middle DOB- I R.1ce"I'S <br />Res- Addtess� City '11 <br />7 Res- Phone- MA Phont� <br />-7 A it- t:j 6, G" <br />, 2: L3 <br />al 1- 741,1 . . .. . . ... . ....... <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 (check box): <br />K Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 ............................................................................................................... . ........ . . . . . . . . . . . . . . . ................................................................ . ....................................................................... . . . ....... . . . . . . . . . ......................... . . . . . <br />The basis for this Notice of Restriction of Use is that on 06"").-Gis— , you violated Section J,c,�Itc) .of tivc Pari: <br />......... ............ .............. . . ....................... — --------------- . ........ .... . . . . ............ . . . . <br />and Open Space Rules, and/or Section '1,1'40 of the Eugene Code, 1971, and/OrORS Tio wit, yioil-v� . . . ........ . ............ <br />LIMA Th-ut I V <br />(Description of the violation.) <br />This restriction of use is effective heginning on ob and shall remain in effect un it 0?)4, <br />if you enter in or use arty City of Eugene park, open space or facility during the effective period of this Notice, you inay be <br />arrested and charged with criniinal trespass in the second degree. <br />Pursuaritto Park and Open Space.Rule.R.4.074 you am entitled to an informal hearing u), contest this Notice, Arequestfur :an <br />inf6rrnaI hearing must be inade in writing and filed with the Parks & Open Space Diviskm Director ("the Division Directoi,'") <br />within 48 twurs (CXCILiSiVC of'weekey.0s) ofreccipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />974( 2. <br />The Division Director shall schedule as time and place for the inforinal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of wieckcnds) of receipt ofthe request for heating. At the inforinal hearing the Division Director will only <br />consider testimony from you, City personnet involved in the incident that resulted iti this Notice, and other witnesses to thie <br />incident, The Division Director may exclude anyone, other than you and those presenting testimoriy, ftoriii the: 4iforynal hicarin <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice off' Excluslon was delivered to the pv rson. namcdat the top of this Notic <br />�te and. 611W-sh"u, n above by, <br />... . . ..... <br />......................... ..... .... .... . . .. ... .... . . <br />ol f -rson issuing/defivering notice) <br />I hereby acknowledge receipi ot'the above Notice on the date and time indicated abov <br />(Signature of persion being iSSLIed the notice) <br />WhIiL; 4upy: Public Wurk", Gweun Copy: Fulc Yel lin ver ( upy, R,,,, pon Pink Copy: ktxipiura OCAT Cupy. Offirra APpmd nui�uc� RW A0, <br />