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<br />NOTICE OF RESTRICTION OF USE
<br />and Notice of Right to Appeal
<br />f CASE
<br />DATE:
<br />LOCATION (PARKJOPEN SPACE):(,�AJ ... . . . ........ . ...... ...
<br />.................... . . . ...... ... ... . . . . . .................. . . . ..................... .. . . .................................... . .. . . . .
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<br />Nanie� Last Fir I Middle NIB:
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<br />Rcs. Addres�s: ("ity, St'i Zip Res. Phoney Work Phore�
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<br />Under the authority of Ad ministrative Order No. 58 -03 -24 -"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 City of Eugene parks, open spaces or facilities.
<br />El
<br />The basis for this Notice of Restriction of Use is that on
<br />.......... you Violated Section, offfile Park
<br />To wit, oLu
<br />fthe Eugene Code, 197t, and/or ORS
<br />and Open Space Rules, and/or Section ............. o Y
<br />r lj'� r r,,
<br />. . . ....... . . . . ................................................... . . . . . . . . . . . . . . .................
<br />(Description ofthe Violation.)
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<br />This restriction of use is effective beginning on!9T1jLi1—'-) . and shall remain in effect until
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<br />..... ....... .. " . . . . ..........
<br />If you enter in or usc any City, of'Eugene park, open space or facility during the ef.16ctive period loif this Noticie, you may ble
<br />arrested and charged with criminal trespass in the second degree,
<br />Pursuant to Park and Open Space Rule R- L074 YOU are entitled to an informal hearing to cornem. this Notice, A request f6r an
<br />informal hearing must be made in writing and filed with the Parks & Open Space Divi done Diiector (1he Division Director")
<br />within 48 hours, (exclusive of'weekends) of receipt ofthis Notice at the loflowing address: 1820 Roosevelt, Blvd®, Eugene, OR
<br />97402.
<br />The I)Msion Director shall schedule as timeand place for the informal hearing to be conducted, wlik'11 shall be not Inorle, than
<br />'72 hours (exclusive of'weekends) of receipt ofthe request for ficaring, At the informal hearing the Division Director will wily
<br />consider tcstirnony front you ', City personnel invoived in the incident that resulted in this Notice., and other witnesst.-s to the
<br />incident. 'rhe Division Director rna.y exclude anyone, other than, you and those presenting lestimcmy, froirn the int.brinal, hearing,
<br />This Notice shall remain in effect pending any requested hearing.
<br />This Notice of'Exclusion was delivered to the person named at the top ofthis Notice at lfic� date and firrile shownabovir t.:)Y�:
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<br />(Sigrratur(..of person issuingg/delivering fac,61r,,,tr`,b
<br />I hereby acknowledge recelpt of the above Notice on the date and time indicated abovie.
<br />(Signature of persi(.)n bein�p, issuied the na�)fice)
<br />White Copy: Public 'away L, Greni C'opy! Fdc� Vdk,",, Copy, Report C'01w NnP, (7o p, RmAptsnk Gokl f1py Oif6u,,.ir ncficc, RL -,v. rl4 03
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