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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />1) A' r t-�: TIME: CASF.I ff� <br />OF <br />I OCATION (P,A.RK/(.)PEN SPACE). <br />.............................. 7 . .......... . ........ <br />Nanic� Lasi Nrs,u MiddleRaCQ/s <br />4 <br />�Z <br />Al <br />e> r, -.T 4 <br />Uj Res, Adclress: (Jily StateRes. phone: VhO"C: <br />rip <br />Under the authority ofAdministrative Order No. 58-03-24-Fand Park and Open Space Rule R-IAKIS(3), you,�,.Ire hereby <br />notified that you are prohibited from (check, box): <br />RE- Entering in or using all City of Eugene parks, open spaces or fAcifities. <br />IX <br />'rhe basis for this Nmice a.)f Restriction of' lis that on lion <br />_ _ . . ............... . you violated Sec <br />Open Space Rules, arid./or Section ............. . . . ----- - ------- ...... of the Eugene Code, 1971, and/or ORLS To wit, <br />MIII <br />(Description ofthic virrflation.r) <br />is restriction of use is effective be, on _10-........ 71 KI , and shall remain in effect until <br />..... . . �5-' <br />if you enter in or use any ity ofEagene park-, open space or flacility during the effdive period (if thisNotice,, you I -w <br />arrested and charged with critninal trespass in the second degree. <br />Pursuant to Park and Upen Space Rule R. -I.074 you are entitled to an in flornial hearing to oc.piatest this Notice, A re�qLle&l I'D[' W-1 <br />informal hearing must he rnade in writing and f1led with the Parks & Open Space Division Director ("ithe Division Direik:,Lior-�� <br />within 4S) hours (exclusive of'weekerids) of receilpt of this Notice at the following address- 1820 Roosevelt, Blvd., Eugene, OR <br />97402.. <br />The Di vis ion Di rector sh a I I schedu l e a. time,:: and place for the i nforn)al head ng t(.-) be cond u ctiexl . w h Ch shal I lxt no I inore, t hari <br />'72 hours (exelusive of'weekends) ofreceipt ofthe request 6or hearing. At the infiormal hearing the Divisionj Director wil I only <br />COTINider testimony from YOU, City personnel involved in the incident that resulted in this Notice, and other witnessici; to the <br />incidew, 'nie Division Directon- may exclude MIYOTIC, other than '.you asci those presenting testirriony, from thc irift)rrrial lieadng <br />This Notice shall remain in effect pending any. requested hearing. <br />]'his Notice offxclusion was delivered to, the person nanned at the top cif this Notice a he q1atc and tirile Alown above hy', <br />(Sig,na,fae l"person iss4ing/dh <br />vering matte .,,e) <br />I hereby acknowledge iceeipt aftht zibuive Notice on the date and tirne indicated <br />being issued the notice-) <br />Wh i le,Cop , 1 u b 11 i c Work, Girccn Copy,Fk, gr ,8I Copy: Repon ir,:'opy 3Nnk Copy� J^old r". or",v p0fflwo Ajlpl�ol w1kcL., Rev. 04,03 <br />