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NOTICE OF RESTRICTION OF USE �*LML�Ab <br />and Notice of Right to Appeal <br />DATFI� L 1� TIME: �-��-v �(., 1 ASEP� 9,7 <br />. . ..... . ...... I,_ - - - --- ------------------------------- I?. <br />LOCATION'(PARKA)PENSPMIE)� ( <br />E- Name, Last First Middle <br />z AU D 0 vL- <br />t+ <br />Rff,. Addr"s� Clity State Zip Res. Phone� Work Phone. - <br />17 i <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule 11-1.005(3), you are herehV <br />notified that you are prohibited from (check box )- <br />X <br />The basis for this Notice of Restriction ofUse is that or) 07W-� 1.5"" ............................... . you violated Sleclion 9 . ................... �of thic Park <br />and Open Space Rules, andJor Section I -- q - L) of the Eugene Code, 1,97 1,ar�dA,)r ORS ...... . . . . TO wit" yiva:- ------------ <br />rl <br />(Description of the violation.) <br />This restriction of use is effective beginning on 10-?Lr'4 t 5 , and shall remain in effect until <br />Ifyou enter in or use any City of Eugene park, open space or facility during the effective period lo F this Notice, you rroy be <br />arrested and charged with criminal trespass in the second degree, <br />Pursuant to Park and (1.)pen Space Rule R-1.074 you are entitled to an infortnal hearing to contest ffiis Notice, A request for an <br />, <br />informal hearing niur <br />st be nade in writing and filed with the Parks & Open Space Division Director ("the Division 1.)JR,011 <br />1 <br />01, ) <br />within 48 hours (exclusive o(weekends) of receipt of this Notice at the f6flowing address:: 1820 Roosevelt, Blvd., Eugene, OR <br />97402® <br />'rhe Division Director shall schedule a time and Place for, the infoirinal hearing to 1:)e conducted, which shall [)e not more than <br />72 hours (exclusive ol"weekends) of receipt of the request for hearing. At the infornial hearing the Division Directeur ,will only <br />consider testimony from yo u, (.1I i ty personnel i nvo Ived in. the incident that resulted in this N oticie, and otheir witnesses, to the <br />incident. The Division Director may exclude anyone, other than you and those presenting tesliniony, from J,-te inibri-nal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top ofthis Notice at the date and time shown aboveby!! <br />(Sigriaturie of'person issuing/delivering no)ticv) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />. . . . . ....... . ......... . . ...... . . . . ................................... . . . . . . . ................................... . . . . . . . ................. . <br />(Signature $15,rpemon being issued the <br />Mac UopyPub& Wur!L.', Uirrmir,.''opy, FiGe Yvflow Copy, Kupon C'cpy Pink (-'cppy. Recirpiem GrAd Copy Dffiwer App"A nuiIk-e, Re,, 0,V03 <br />