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<br />NOTICE OF RESTRICTION OF USE
<br />and Notice (if Right to Appeal
<br />DATE: TIME: CASE
<br />1jr (9' --
<br />LOCATION (PARK/0PEN SPACE).,_,
<br />................... . ........ P . & ............ . .
<br />NarrtQ: Last First Middle 1)013� Race'se
<br />M 1`0
<br />6 d WXUZA 05 VMS—
<br />. . ....... .
<br />thea. address.;: City State Zip Res. Phone� Work Phone:
<br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are heirelby
<br />notified that you are prohibited from (check box):
<br />191-- Entering in or using all 0ty of Eugene parks, open spaces or facilities.
<br />x
<br />`The basis for this N oti cc of Restri cd on of' Use is that on __DD ..... you violated Sec tim i rr r r ofthit, Park
<br />Lind Open Space Rules, arld/Or Section d,sa-of the Eugene Code., 1971, and/or OR To . . .. ..................
<br />..............................................................................................................................................
<br />(Description ofthe violation.)
<br />This restriction of use is effective beginning on-0-7-,,�, , a Ind s hall rema in in effect until
<br />Ifyou enter in or use any City of'Fkjgene park., open space or facility (luring the efTective period of this, Notice, you may be
<br />arrested and, charged with criiI trespass in the second degree.
<br />Pursuant to Park and Open Space Rule It 1.074 you are entitled to an infonnal hearing, to contest this Notice, A. request r,,,,,,,
<br />infornial hearing rnust be made in writing and Filed with the Parks & Open Space Division Director ('11-te Division [Arector")
<br />within 48 hours (exiellusive o:,)foeckends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, Oat
<br />97402.
<br />The Division Director shall schedule, a time and place for the informal hearing to he conducted, which shall be not mora: than
<br />72 hours (exclusive ofweekends) of'receipt of the request fbi- hearing. At the inf-brinal hearing the Divisit)jri Director will only
<br />consider testirnonyfrorn you, City personnel involved in the incident that resulted in this Nwice, and other wtne.ssit.,�s I thie�
<br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, ftom the informal he,,,iring,
<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 of this N e, at the date and time sl, -n own above Iby
<br />rc ofperson issuing,/dcbverind.p ni(aticc)
<br />I. Ihereby acknowledge receipt (3f the above Notice on the date and time indicated ab(,.)ve,
<br />r s
<br />(Si ure of pileo nt mein g issued the noti c e),
<br />Whirc Ccqiy. Pubfic, Woii krs Gir In Cupy, lllc Yenow Copy, II Copy I (.'cqay: kccipieni irikri(i crpyiir')rrir.,.i. �i,jr,pui R. I
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