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NO'l"ICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATH: TIME: CASE ff: <br />--j <br />LOCI Al-'101'4(PARK/()PEN���,�'ft'A,(E): <br />Name:: �,a,,t Fara Middle DOW Izacc/sex.- <br />L' A <br />Res. Address: cl-I ale Res. Photle: wod"', Phorw� St, Zip <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you arc hereby <br />notified that you are prohibited from (check box): <br />P, <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />............. - - ---- .. ..... . .. . . . .. . .. .. . . ................................................. . ......... .. . <br />you vlo <br />The basis forth is Notice of'Restriction ofUse is that on L hated Section of the Parl�r <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, anWor ORS I ovrft' <br />.............. <br />.....!Y .. . ................................................................. . . ........................................................................... . <br />(Descfiption of the violation.) <br />k <br />"I'his restriction of use is effective bvginning on <br />and shall rentain in effect unfil <br />Ifyou enter in or cruse any City of Eugene park, open space or facility during the eff5ective period of this Notice, YOU may he <br />arrested and charged with crirninal trespass in the second degree. <br />Pursuant to Dario: and Open Space Rule 1C.-1.074 you are entitled to an informal hearing to contest this Notice. A recltiest foran <br />Informal hearing inust be rnadc in, writing and. Filed with the Parks & Open Space Division Director ("Ifie Division Director ) <br />within 49 hours (exclusive of weekends) of receipt of this Noticeat the fbHowingaddress: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the inforrnal hearing tel be conducted, which shall be not more than <br />72 hours (eXCIUSIVC Of'WeACII(IS) 01'reccipt of the request for hearing. At the infotinal hearing the Division Director wii I only <br />consider testirnony frorn you, City personnel involved in the incident that resulted in this Nmice, and other witnesses br,) the <br />incident, The Division Director may exclude anyone, other than you and those presenting testimony, fi-om the informal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered tothe person named at the top ofthis Notice at the date �-ttnnc shown above by <br />J.......... <br />(Signature of person issuing/delivering noflee,) <br />I hereby acknowledge receipt of above Notice on the date and time indicated above, <br />s( i 05'eing issued the noticie) <br />........... . ..................... .. ......... .... .... <br />S atu c Of per <br />Whk k!c'qjy� PqNkc Work� Green File YeHr'�W Copy� Report Copy Pi ii k, Copy: R � c ' p �en t Gcdd Uopy� Offic'eir Appeod noliive H'ev' 0,11103 <br />