NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIML CASIF 1k: <br />. . . . . . . ................... . . . .............. ------------ - -- . . ................................................................. . .. . . . . . <br />LOCATION (PARKJOPEN SPACE):_,j 11 J. -Y . ............... . . ............... . . . . . . . . . . . . ... ................................................ .. .. .. .. . . . . . . . . . . <br />NarncLast First MiMe 1)013- Race/s Pk' <br />eN <br />Res. Ad(JNSS� city State Zip Res. Plicjne: Work Phone: <br />A4 <br />. . ........ <br />Under the authority of'Administrative Order No. 58-03-24 ,F and Park and Open Space Rule R 1.005(3), , you are hereby <br />notified that you are prohibited from (check box): <br />Entering in or using all 06, of Eugene parks, open spaces or facilities. <br />El <br />. . . . . . ............ . ...................... ..... ..... <br />-The basis for this Notice of'Restriction of Use is that onthe Park <br />. .... . ............... <br />-_7 you. violated Section <br />an(] Open Space Rules, and./or Section of the Eugene Code, .1971, and/or ORS r . .. . ................................................... o wit, :,'km <br />I WIM-D AA-ACCAQ <br />(Description of the violation.) <br />This restriction of use is effective beginning on nd shall remain in affect until <br />If you enter in or use any City of'Eugene park, open space or facility during, ffie effective period of this Notice, you may be <br />arrested and charged wiffi criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule, R.-1.074 ya)u are entitled to an infionnal hearing to contest this Notice, A requestFor zul <br />ulfornial hearing must be made in writing and filed with the Parks & Open Space Division Director ("the lr)ivision Dirlectcw"') <br />within 48 hours (exclusive of weekends) of receipt of this Notice at the following ad -dress,:: 1820 Roosevelt, Blvd., Eugene, OR <br />97401 <br />'The Division Director shall schedule a time and plaec for the informal hearing to be conducted, which shall be not iinore than <br />72 hours (exclusive of weekends) of receipt of the request f6r hearing,, At, the informal hearing the Division Director vJl I only <br />consider testimony ftom you, City personnel involved in the incident that resulted in this Notice, and other wir nesse.s Lin the <br />nicident. TheDivision Director may exclude anyone, other than you and those presenting testimony, from the inflornial hearing, <br />rhis Notices call remain in effect pending any requested hearing. <br />This Notice of Exclusion del1wred to the person narned at the top of this Notice at ue to and 6, n abo),,c by� <br />........ ... .----- .................. . . . . <br />(Slnotice:)...... ... <br />I ofper�on issuing/dclivering I �Iry <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature ol"person being issued thee. notice) <br />Whar Cupy: Public Works Green (.7c,py: File YC filmY COPY: R�1,1 ITJ. ('fi)J)y Pink (:opy: R,..,.oqut,-nt Guld Copy�(X.Ece-r Allipml noucr,f.- k",", 04,1,13 <br />