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NOTICE OF RESTRK-TION OF l -ISE <br />and Notice of Right to Appeal <br />DATI..-,'� 10717? . ... . .......................................................... TIME:: /A� . . . . .. ....... CASI" H <br />I vtpra"" r., <br />L,0(.'ATi()N (PARK/OPEN SPA(.'E): <br />N, n L A First r- Middle <br />RZ) A4 <br />±"47 <br />Res, AddTeSS: Cilly State Zip <br />Dofi. <br />01111 —1/ <br />1371k <br />Work Phonitr <br />U} der the authority of Administrative Order No. 58--03-24-F and Park and Open Space Rule R-1.005(3 , yoth are herel..WY <br />notified that you are prohibited from (check box)-. <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />......... ......... . . ........ . .......................................................................................... . . . . . . . <br />The basis fi)r this, Notice of'Restriction ofUse is that onyou 7 vio�latied Section ------------- ofid-te, Pairk <br />07(71-5- - ------ <br />of the E'ugene Coq, 197 1, and/or ORS .................... . . TO Wit, Y10LL___ <br />and �Open Space R.Wes, and/c)r Scct on 7 <br />j. ............................................................. . . . . ....... . . <br />(Description of the violation.) <br />This restriction of use is effective beginning on—L, 7-17.6-1 and shall remain in effect until <br />If you enter in or use any, City of Eugene park, open space or facility during the effective period of fl-,iis Notice, yr,:)u i'ar,.1Y be <br />arrested and chargef.l with crimin-al trespass in the second degree. <br />Pursuant to Park and Open Space Rule R. -I.074 you are entitled to an inf6rmal hearing to contest this Notice, A requiest fir-)ir an <br />infixon-nal hearing mu st be arnaide, in writing and filed ed with the Parks & Open Space Div is ion [Nrector ( "the I-Nvision Direic h --n") <br />Mthin 49 hours (exclusive of Weekends) of receipt ofthis Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director .shall schedule a time and place for the inkbrmal hearing to be conducted, Which shall. be not nu.me than <br />72 hours (ex c I u s ivc of wrw ccke~nds) of receipt of the request for hearing. At the i n for. -mal hearing the Division. Director w i � I in nly <br />consider testimony fi-orn Y(At, (-"ity personnel involved in the incident that resulted in this Notice, and other witnesses tic, the <br />incident. 'The Divisk')n Director rnay exclude anyone, other than you arid those presenting tesfirriony, ftorn the unf'orniifl hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />[his Notice cif Exclusion was delivered to the person nanied at the top of this tu-ne shown abovie lr-,uy: <br />L .. . . ..... ..... ... <br />........... ...... ... <br />(Si^tr-c of'perqon issuing/delivering notice) <br />I hereby acknowledge receipt of"the above Notice on the date and time indic4�"LalaW"Vcl <br />L <br />-I . ... . . ................................ . ....... . ... <br />inng, issuc"d the nuticc) <br />(Si lature <br />Whuc Cojjpy. Pubha ; Work;, Own (7olpy F1 ar- Y,--,J1ovv (.:opy: Repat Copy Pink CopyIkecipienn Guh.J t rrrjp.y. Offivcr Ajrptd rut qi �ce Rr,rev, D-Vr,"' <br />