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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />l(LDM T., C �j . . . .............. . . . .. .......... TfME� ----- 05-.113 CASE ft: - 1,57;;� <br />LOCATION (PARKAVEN SRNCE)�3, <br />4 <br />me� Lasi, F irst Midtlic DOB� <br />City State Res, llhonc� Work Plione: <br />Res, Address: Zip <br />Under the authority ofAdministrative Or No. 58-03-24-F and Park and Open Space Rule R .,,,1 .00543), you are herelby <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />W <br />The basis for this Notice of Restriction of Use is that on "A .11 of thee:; Park <br />—0 you violated Section <br />and Open Space Rulc�, wkd/or Section.. <br />o fthe Fu gene Code., 197 1., and/or O.fix YZI SIT, VV i t , ycw <br />. . .. ..... . . . ............ . <br />(Description of the violation.) <br />This restriction ofuse is effective beginning on..-o-1z2—qff—, asid 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 this Notice, youa may be <br />arrested and charged with criminal trespass in the second degree. <br />pursuant to Park and Open Space Rule It -1.074 you are entitled to an inforivial hearing to contest this Notice. A riiable St Ifbr an <br />info al hearing must he inade in writing and filed with the Parks & Open Space Divisior) Director ("the Divisitm Dircck�nr,`) <br />within 48 hours (exclusivc ofweekends) of'receipt of this Notice at the following addresh: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall scheditlea time and place fear the informal hearing io be conducted, which shall be not more than <br />72 hOUrs (exclusive of weckends) ofruccipt of the request for hearing. At the informal hearing the Division Director will only <br />consider testiniony from you, City persq,)nnel inv�.)lved in the incident that resulted in this Noticle, and other witnessie,,s, to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, the int"ormal he"'aring, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of'Exclusionwas delivered to the person named at the top of this Noq�vieflt the date and time shovin above b�y: <br />I hereby acknowledge rieceipt of the above Notice can the date and tin'te i <br />of person issuing/delivering notice) <br />cd above <br />.. . . ... ............... ... <br />. . ..... ... ... <br />(Signd(6re of'pen,'m enig issued the notice) <br />1AIN111C CUP)r: Kdlhl.. W000' Green<.'upy; Re. Yuffx4v Copy Rpco a:;,opyr Pink C'opy� Recapien� Got N Copy, Officer A.qwal no 6c'e <br />Rev, OA/01 <br />