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NOTICE� OF Rt:xrRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME� CASE <br />...... . ... . . <br />M."ATION (PARK)OPEN SPACE) <br />ahv _gx"r . . . . ....................... . .............................................. . . . . . . . <br />Namc; Last FiTZA Middle ta(r Racie/Scx: <br />AV ilro tL 0 S'N a L4 ar" L HLILUAM6 A4 <br />Res. Address: C'nV state Zip )Fk.es. Phonc� Work Phonii <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are herehly <br />notified that you are prohibited from (check box): <br />El <br />The basis for this Notice of Restriction ofUse is that oil You viol'a'ted Section I a 10& ) fthe Park <br />and Open Space Rules, and/or Section — --------- ei ( the Eu gen e Cod c� 1971, and/or OR.S ................... . To Wit" you`— <br />ov <br />.................................................... . ...... . . . ...... ...... <br />(Description of the violation.) <br />This restriction of use is effective beginning on —ILI IV and shall remain in effect until . . .............. .. .. .... . <br />If you enter in or u.w any CJ(y of Eugene park, open space or facility during the effective period of this Notice;, yuu inay be <br />arrested and charged with criininal trespass in the second degree, <br />Pursuant to Park and Open Space Rule R-1.074 you are entitled to an informal hearing to contest LM% Notice. A reir.luest for an <br />informal hearing must be made in writing mid filed with the Parks & ("Ven Space Division Director ("the IDiwision 1"hil"eClOr i"r ) <br />within 4.8 hours (exc lu s ive of w eekends) ofreceipt of this Nod cc at the to] lowing address- 1820 Roosevelt, Blvd, Eugene, OR <br />97402. <br />The Division Director shall. schedule a time and place for the inf6nnad hearing to be conducticid.,which shall be aot more than <br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division DiTectii,.)r WHI only <br />Consider testimony ftOM YOU, City personnel involved in the incident that resulted in this Notice, and other witnesses do i <br />incident. The Division Director may exclude anyone, other than you and those presenting testinlony, ftorn the inforrna11 hicar4q,!, <br />This Notice shall remain in effect pendiog any requested hearing. <br />This Notice of'Exclusion was delivered to the perrson named all the top of this datcand time, shown abovir,,T'by�: <br />*444� lb� <br />..... ............................................................................................................................................................ <br />(Signature ofperson issuing/delivering, not]0.9 <br />V <br />I hereby acknowledge receipt of the above Notice on the date anti time indicated above. <br />(Signature of'person being <br />, issued t:luer notice) <br />whac Copy F°uhb iii W1414 Gn'T.n (7(7pyHe YLMmCupy: Rup)Tl Copy Pink Copy: Recipient GaU CtTy: iOffiti cii Appreall noitkrw k1" o . 0,11 '03 <br />