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I -A <br />NOTICE OF RESTRR OF USE <br />and Notice of'Right to Appeal <br />�0 <br />DATF.,: 33711 ("--'AS E ft: <br />. . . . . . . . . ................................ <br />TIML <br />LOCATION (PARKJOPESPACE)�� A, <br />��kj-7E- <br />rnc� ..,ast Middle DOW Y t! "Sc, <br />z <br />Res,. AkldrcssCity State Re�i. Phone- Woyk Pfiune:' <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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />0 ........................................................................................................................................ I.– . . . . . . ................................................ . .................. . . . ............ . ...... ------- <br />The basis for this Notice of'Restriction of Use is that on7��a, you vi(flated Sectk�)n ............ <br />of theP'aric <br />__0 <br />Open Space R.0 I c%, and/or See 110n, - _ . — -, of the Eu gene Code, 197 1, andlor OR. S I To wit, y0k,C­­_­._ <br />'.�W F `il � <br />(Description of the violation.) <br />This restriction of use is effective beginning on <br />Y_�, and shall remain in effect until <br />if you enter in or use any City, ofEugene park, open space or faci I i ty d uri ng the c Met] v e period of thi s Noboo, you nlay be <br />arrested and charged with criminal LFCSp8SS in the second degree. <br />Pursuant to Park and Open Space Rule R-1 .074 you are entitled to an informal hearing to contest this Notice. A request firrarr <br />informal hearing must be madc in writing and filed with the Parks & Open Space Division Director ("the Division Director"') <br />within 48 hours (exclusive ofweekends) of receipt of this Notice at the following address', 1820 Roosevelt, Blvd., Eugene, OR <br />97401 <br />The Division Director shall schedule a firne and place for the informal hearing to be conducted, which shall be not. rrioriu, than <br />72 hours (exclusive of weekends) of receipt of the requcst for hearing. At the int'ormal hearing the Divisicin Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice., arid other witnesse.,; 110 the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, tilom the informal hearing, <br />This Notices all remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top ofthis at ffie date and time shoawn above by: <br />(Si -rature of person issu ing/del ived rig notice,), <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />........................................... . ._ .............. . . . ............... . ... . ................................... <br />...................... . . ........ ; �, <br />.... ....... <br />(Signaterre ofper........ <br />sion being isslued the nwioe)i <br />Whin: Fnj,.iy: Public Workr,, 4.n -pion Copy. File ydluria CCT',Y: Reporl Copy Pink, CuryRmiviolL (3463 ir. npy, Olflc:rApj.wdnwic�c 'Rev. 0-11403, <br />