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NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
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<br />LOCATION (PARK/OPEN SPACE) T — - ----------------------------- -
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<br />Narne: Last First Middle 0013: Race. /ScXV "
<br />Res, Addres& Cit Zip Res, Phc.�ne:
<br />y State Work Phune�
<br />'IKLINI-Y' -1 (7 - al—
<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.
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<br />The basis for tlii� Notice of Restriction of Use is that on a( you vicilated Siectk,)n, 'of flie Park
<br />01--11— - I .................. . . ........ 0.
<br />and Open Space RiAes, and/or Section of the Eugene Code, 197 1, and/or ORS TO Wit, ),'OW.
<br />CC,j+j e
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<br />Description olf the violation.)
<br />2 J
<br />This restriction of use is effb
<br />ective eginning oni(��h(zl--.J and shall remain in effect un tH 2
<br />If you enter in or use any City of Eugene park, open space or facility during the effective period oif this Notice, you may be
<br />arrested and charg'ed with criminal trespass in the second degree.
<br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an intorinal hearing to conte-st this Notice. Arequi e.sff6rant
<br />infornial, hearing tnust be made in Nxriting and filed with the Park's & Open Space Division Director ("the Division Director")
<br />within 48 hours (exclusive, of weekends) of receipt of this Notice at the following addrcss° 1820 Roosevelt, Blvd, Eugene, OR
<br />97402,
<br />The Division Director shall schedule a time and place for the inrormal. hearing to be conducted, which shall be not rnon',,., than
<br />72 hours (exclusive ofwieek ends) of receipt of the request for hearing. At the informal hearing the Division Director vill onty
<br />consider testituony frornyou, (Jty personnel involved in the incident that resulted in this benefice, and other witnesse,,s to thi.
<br />incident, The Division Dit-ector may exclude anyone., i'Aher than you and those presenting testiniony., frorn the, informal he,,iring
<br />This Notice shall remain in effiect pending any requested hearing.
<br />'rhis Notice oH-.,xc1tu, ion was delivered to, the person named at the top of this, Nouceat ti Date a,ruj Ii ,shown abovc',. by:
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<br />(,Signature of persr,�)n Lssuing�/dchvering notilcir)
<br />I hereby acknowledge receipt of the abovie Notice on the date and tirne indicated above,
<br />(Signaturc, of person. being issued the nodicc„r)
<br />'Khi:le Copy Pubhc Work,; Gr'ecn Copv� Hh'. Yelbwpv ("opy: Report Copy Pink Copy, Rucipient G101d rr.'opy, r.tPYrr .rr Appeal noiice RvNV03
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