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NOTICE OF RESTRICTION OF LISE <br />and Notice of Right to Appeal <br />lyra" 1_-1 <br />...... . ...... ... TIMR: CASE 0,., T3 . . . . . .. .............. ... <br />LOCATION (PARKJOPEN SPACE)�: An -k <br />. . .. . . ....................................... . . . . . . . . . . ..................... . . . . .. . <br />. .................... <br />A., <br />Ci <br />Narne: Last FD <br />iTSt MiddIc 0173: e- Racc/SoX, <br />C, 3 <br />Rcs. Addre&s: City. State Zip Ines. Phone: Wodc Phoyle: <br />Under the authority of Administrative Order No. 58-03-24 .F and Park and Open Space Rule R-1.00(.3), you are hereby <br />notified that you are prohibited from (check box): <br />VEntering in or using, all City of Eugene parks, open spaces or facilities. <br />Cl <br />lane basis for this Notice of Restriction of' Use is that on <br />7 10 of thc,,, Mark <br />and Open Space Rules, and/or Section qVj1q of the Eug-crie Code, 1971, iand/cr ORS To Mt, You <br />.............. . ------- <br />(Description of the violation.,) <br />This restriction ofuse is effective beginning on Li , and shall remain in effect untill /M <br />If you enter in or use any City of Eugene park, open space or facility during the effective period ofthis Notice, YOU 1 -nay l --)e <br />arrested and charged with criniinal trespass in the second degree, <br />Pursuant to Park and Open Space Rule R-1.674 you arc entitled to ark informal hearing to contest this Notice. A request f6r an <br />informal hearing must be made in writing and filed with the Parks & Open Space Division Director ("the Division [Nrectr,�W`) <br />),vithin 48 hours (exclusive of weekends') of'receipt of thi,,i Notice rat the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the in1br-mal hearing to be conducted, which shall be not more than <br />'72 hours (exel us ivic of weeken ds) of receipt of the request for hearing. At the infbanal hearing the Di vi si on Dircoor will o nly <br />consider testimony ftom you, City parsonnel involved in the incident, that resulted in this Notice, and other witnesses to the <br />incident. The Division Director inay exclude anyone, other than you and those presenting testirnony., frorn the infoanal hearing. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person namedat the top of this Notice at the date and tirne shown abovic <br />(Signature of'Verson issuing/delivering notice) <br />1 hereby acknowledge receipt of the above Notice on the date and time indicated abovr. <br />(Signature of pers(,.m being <br />; issued the <br />W h I �e Copy: i9 lia b I i c Wu V k ,, Grucn Cujpy: Hu yeflow Copy: Roped cbpy Pwk Capy: Rec pe n k CkAd Copyfflfwcr Appral nuficc Rev0-1/01 <br />