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NOTICE OF RESTRICTION OF USE, <br />and Notice of Right to Appeal <br />Z' <br />DATE: FX9 YIME: qoLqo <br />LOCATION (PARK./(..-.)P1.�,N SRNCT): <br />. . ................ . . . ........................................... .. . . .. . ............................. . . . . . ............. <br />U nder the autho R-Ity of Administrative Order No. 58-03-24-F anti Park and Open Space Ru Ile R. -I.005(3), y10 u arc hereby <br />notified that you Are prohibited from (check box), <br />Entering in or using ali City of Eugene parks, open spaces or facilities. <br />El <br />The basis for this Notice of Restriction of Use is that on <br />. . ......... you violated Sectionof"thic lla,ik. <br />. ..... . . .. ............ <br />and Open Space Rules, und/or Sectionl!:!�--e ofthe E ugene Code, 1971„ and/or OR,, To Mi, you........_........_ <br />.......... L 2. F-,, <br />. . ........ . ................. ... . . . .......................... . <br />. ............................................................. ..... . . . . .. . . . .. ....................................................................... <br />(Description of the viola -tion,) <br />This restriction of use is effective beginning on ;zd iba", restrain in effect until 107 <br />. .. . ................. . <br />If you enter in or use any City of Eugene park, open space or facility dt.ffing the effective period of thus Notice, you may be <br />arrested and charged with criminal treqpass in the second degree. <br />Pursuzint to Park and Open Space Rule R- 1.074 you are entillcd to an informal hearing to contest this Notict-. A request fic'n- ari <br />infcmnal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division Divectcn--) <br />within 48 hour's (excl u sive of'weekends) of receipt of this Notice ait the foliowing address : 1820 Roosevelt, Biv d., E ugene, 0f <br />97402. <br />The Division Director shall schedule a time and place for the informal hearing to be conducted, �vhkli shall be not 111orc. tharl <br />'72 hours (exclusive of wcokends) of'receipt of the request fear heat -41g. At the infomial hearing the Division Dircck.,Pr will only <br />consider testimony from you, try personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testin'rony, from the irjfbrmal �, icaring <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice t.)f Exclusion was delivered to the person narnedat the top ofthis Notice the date d hownabovt-,,�.-)Y: <br />. ............. . . . . . . ---- <br />(Sig aaaat <br />...(S lire 0erson issuii gr/delivuring un tics ) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated abovc, <br />............ ............. ......... . ....... . ......... . . .......... <br />S si� t <br />'n,'Ire t)t l�,r, <br />ignature o[person beirig, ksued k t, <br />whk Ccupy� Pm, biic IdVorks Grc'am Copy: He Yi,VgOW COPY, RC]3017. COPY PITA copyRecipiemGcfll d Copy: D frfii cer A p M noi[itprs K,w, i,W,03 <br />