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NOTICE OF RESTRICTION OF USE <br />and Notice of'Right to Appeal <br />DATL 'I'l M E: PlIk" (..'AH' tk <br />. ...................................... . . <br />LOCATION (PARK/OPEN SKA(.','Q----- <br />Murie; Las[First Middle DOIB� Ra c c iS �,�,x <br />7- 4r11-1 <br />,5 <br />Res. Address: City Mate Zip RLO"S' PllclflC:: Work Mwne <br />1� <br />Zip <br />" 17 J� <br />0W <br />Under the authority of Administrative Order inn® 58-03-24-Fand Park and Open Space Rule 11-1.005(3), you are hereby <br />notified that you are prohibited from (check box) - <br />X Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 <br />. . . .. . . ..................... . . . . . ........................ I ........................... . . . .. . .... . . . . ......... . ............................... . ........ . . ..... . . . ............... . . . . . . <br />The basis for this Nod cc of'Restriction (.-,wf l_Jse is that on, 0 6 )4 1 'olated Section q <br />. ............. . . You %,] JjO ........... . . " ofthe Park <br />and Open Space Rtdes, and/or Sectionq�0-1..0' Of the.bUgeTle Code, 1. 97 1, andlor OR To wit, ywz <br />........ . . <br />...................................... . ......::.-:.v._ . . . ............. ........................................ . ............... . . . . . . _­­­___...._­ . . . . . ...... <br />(Description oftheviolation.) <br />This restriction of use is effective beginning on, 06 and sball remain in effect until 0 7 XL (�7' <br />............... . . ............. ........ <br />if you enter in or use any City of Eul,,ene park, open space or facility during the effective pi,,,,fiod (.4'this Mr)ticz, you rriay be <br />arrested and charged with criminal trespass in the second degree. <br />pursuant to Park and Open Space Rule R.4.074 you are entitled to an intiornud hearing to contest this Notice. A request fim an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 49 hours (exclusive of'weekends) of receipt of this Notice at the following address:' 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall whedule a time and place for the infor-rnal hearing to be conducted, whiai shall be rtoL more than <br />72 hours (exclusive of4cekends) of'receipt of the request for hearing. At the infornial hearing the Division Director vrd[ only <br />consider testin,iony ftom you, City personnel involved in the incident that resulted in this Notice, and other witnessir.':S, to thr, <br />incident. The Division Director rnay exclude anyone, other than you and those pr cst:nting tirstirriony, frorn the infbIrmai hearing, F <br />This Notice shall remain in effect pending any requested hearing. <br />te by� <br />TN <br />his Notice ash Exclusion was delivered to the person narned at the top of this and i above <br />............ .... ...................... <br />(Signature of'person is'"firly/kic...cr' <br />I no6iue) <br />I here by acknowledge receipt of the above Notice on the date and time indicated above, <br />I <br />– -- — --------- - <br />(SignUtUre of'person heink, issued the notice) <br />Mike (2op.y: PNI Wou-6 Gywc�RiL CopyHe.. Ychow Copy: Repon Copy Nnk Copy Rerr:q1wn1 I.4 o,ray! Oflkri.,r Appuml ri,.Aioe Rr.ev. I'M , ;03 <br />