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NOTICE OF RESTRIc"rION OF USE <br />and Notice of Right to Appeal <br />-1-lME- 2",C)'O A <br />. ................ . . . . . . ................. .... CASEft: . ........... . ............. .. .. . .. . . 7. <br />LOCATION (PARK/OPEN SF`ACF):__ &L <br />. . . ....................................................... . . . ...... .... ...... ......... . ...... <br />Narne, Last First Middle DOID�: Race/Sex� <br />V, -X Ci <br />Res. Addm,',s t r S,I a j;te Z i P Res, Rime: Work Plione: <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R 1.005(3), you are herieboy <br />notified that you are prohibited from (check box It <br />Entering in or using all City of Eugene parks, (open spaces or facilities, <br />. . . . .............. . . . . . . . . . ................ . ....................................................................... . .......... <br />1"he basis for this Notice of Restriction of TJse is that on 01-;L&VSr' I You Violated Section --- of the Plark <br />I ..................... <br />and Open Space R.tiles, and/or Section P)-40 of the Eugene Code., 1971, and/or ORS IFol wit, You: <br />5 �5 LV V4 <br />.............. . ............................................... . ......................... <br />(Description of the violation.) <br />This restriction of use is effective beginning on 4.-9 W-0 l `o-� and shall remain in effect until, c> 7)-C <br />. ..................................... --.:I <br />Ifyou enter in or use any ( - I try of Eugene park., open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criniinal trespass in the second degree. <br />Pursuant to Park and Open Space Ru le 8-1,07 you are entitled to an in fix -mal bearing to contest th is Nonce, A request ["or an <br />itiffirmal hearing must be made in writing and filed with the Parks & Open Space Division Director (,"the Division Dircctir-)r-) <br />within 48 hours (exclusive ofwimkends) of receipt of this Notice at the following address: 1821) Roosevelt, Blvd., Eugene, 01-t <br />97402. <br />The Division Director shall schedule a time and place for the infiort-nal hearing to be conducted, which shall be not more than <br />72 hours (exclusive ofwcukends) of receipt of the request for hearing. At the infoi-nial hearing (lie Division Director will only <br />consider testimony from you, (7ity personnel involved in the incident that resulted in this Nolic.(% and other witnessies to the <br />incident. 'The Div isi on Di rcctor may exclude anyone, other than you. and those present irig testi mony, frotri the informal heari nt, <br />This Notice shall remain in effect pending any requested hearing. <br />This N ot ice o f Exc I us K.)n gars delivered to the person narned at the top o f th i s Ntuptucc <br />due e amnia S y <br />. .......... ........ . - . ......... . .................................. . .......................... <br />ofpc Iri <br />(Signaturc ofpc s 6 'r ng nonice) <br />I hereby acknow'kedge receipt of thie above Notice cin the date and time indicated above. <br />----------- - - <br />(Signature of person beirig the iroficie,,b <br />yklnte Copy. Pivhlic Wes,, Gir",n (.:opy� Ffl,..�YiAhlw CupyRepcd r'opy Pink k opy� Rc.cipkmt f iold Copy: Offioer Appua) rRvvIk;c-. RfR,110 <br />