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NOTICE OF RESTRICTION OF USE tv <br />and Notice of Right to Appwal <br />DATF� <br />....ir <br />................... . . . . I . . .... ..................... . . . . . ......... . ............................ I .... . . ....... . . . ............ . <br />Vbu— <br />. ......... . ........... . ..... . ..... . . - ­­ ......... . . ......... . . . ......................... . . . .... .. . ............ . . ------- <br />NadeTa,,t '—f First Middfe DOB� Racc/Sex: <br />-2 . . . . .......... <br />o Y, (,j Ir, <br />lZes. Adtlress�� city State Zip Phvg�c-: Ww-k ilhcjne�: <br />-7 <br />61�&111 CA?— <br />Linder the authority of Adminirstrative Order No. 58-03-244'and Park and Open Space Rule 111-4.005(3), yowl are herieby <br />notified that you are prohibited from (check box): <br />§( Entering in or using all City of Eugene parks, open spaces or facilities. <br />FJ <br />U <br />The basis for this Niotte(, of Restriction �of Use is Lhat on Cj-71jP1J' you violated Siecti(.in ofidw I ark <br />. . ........... . ............. .................. .. . . <br />and Open Space Rules,, andJor Section. of the; Eugene 1,97 L, and/or OR -S To wit, ylr,.)U., <br />. ......... .. <br />. ... .......................................... . ...... . . . . ............ .. . ... . . ........................... . . ................. . ..................................................... . .... . . . . . . .............................................................. ---- . . . .. . ........... <br />(,Description of the violation.) <br />This restriction of use is effective beginning on -712 and shall remain in effect until <br />... ...... _ <br />If you enter in or use any City of Eugene park, open space or facility during the effective period of tl6s Notice, you rnay be <br />arrested and charged with criun nal trespass in the second degree. <br />Pursuaritto Park and Open SpaceRule R-1.074you are entitled to an inf6rinalhearingto contest this Notice, Areqaiestft:jr;an <br />informal hearing must be niade in writing and filed with the Parks & Open Space Division Director ("'the Division [)ir°icior'—) <br />within 48 hotus (exclusive of %veekemis) of receipt ofthis Notice at the f6flowing address1820 Roosevelt, Blvd., Eugene, OR <br />9740 . <br />The Division Director shall schedule as firrie and place for the informal hearing to be conducked, whichshzill be not 1-noric than <br />72 hours (exclusive of` weekends) of'receipt of the request I`or hearing. At the infkvmal licaring the Divisic)n Director will only <br />consider testirri[ony ftorn you, City personnel involved in the incident that resulted in this Notkr,e., and other witnesses to'thyc <br />incident, The Division Director may excluckr- anyone, other than you and those presenting testiniony, ftorn the inforinal <br />This Notice shall remain in effect pending any requested hearing. <br />This Noice of Exchv��ion was delivered to the person narned at the top of this Notice at the date and ft'ine shown ai-)ove, by: <br />(Signattire of perso�n issijirqv/deliviering nuiiicie,) <br />I hereby acknowiedge receipt of the above Notice on the date and tixne indivatcd above. <br />%'SignatWred'person being ssucd the not <br />�A,161K, Gtvv Pahhr,10rrxrbNnnm Cop�,,, : Hle YcIlow rr"upkelporl Cupy Tlink Capykcf.opi�ml Gold Copy: C) B:er Aripeal rmurraVvn, (4103 <br />