5`�S 1 1,�55!505 I <br />NOTICE OF RESTRICTION OF USE k <br />and Notice of Right to Appeal <br />DATE. 017 6 TIME: CASL,#: <br />.......... <br />-6 .... . . . . .. ........ ---------- ................ .. . . . <br />LOCATION (PAR K/0PEN SPACE) _5kcd_es' ls' <br />........... . ............. . . ...... . . . . . ................... . . . . . . . .......... I ............... . . . . ...... . ......... <br />Namo: Last First Middle DOB) Rac'v,/Sex� <br />Res. Addresscity State Zip Res. Pbonc: Work Pllorle� <br />LJnder 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 facilifil <br />. . . . .................................. . ............. __ . ...................... . ............ . .... ....... . . ........ . . . ............. . ........................... . .... . ... ___ . . ......... - ------ <br />The basis for this Notice of Restriction of Use is that on ,you Violated section b(>1�-4' oftheflark <br />. ... ..................... . . . <br />and Open Space Rules, andfor Section of the Eugene Code, 197 1, andJor ORS Towit, yotl . . . ...... _...........m <br />(Description of the Violation.) <br />This restriction of use is effective beg] noting on 070K and shall, remain in effect until 0? Cq <br />If you enter in or use any C ily of Eugene park, open space or- facility during the effective period offhis Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space hole R-1.07 you are entitled to an informal hearing to ccuitest this Notice. A. request f6r an <br />informal hearing must be rmade in writing and filed with the Parks & (.)perr Space Division Director ("the Division Directior") <br />within 48 hours (exclusive of'weekends) of'reccipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time cind place for the infornial bcaring to, be conducted, which shall be not rnoric than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the iril'onnal hearing the Division Director will only <br />consider testimony From you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude any(me, other than you and those presenting testin-lony, From the inbonnal hearing. <br />This Notice shall remain in erfect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at the date and time shown above by: <br />........... ------ ---- <br />(Signahire of' person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signaftll"e cff persion being issued the notice) <br />White (_'Ofsy pi. hHc Work,; Car."'cn Copy! Fflc Yf.,Hcw (Lora` Rporl Cc)py pmic C`Sqy' Kt'r"ipiept 6,dd (_"upy(3fficcn, Appmd nAcp rh:v, 0411(0 <br />