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NOTICE OF RESTRICTION OF USE
<br />and Notice of Righttun Appeal
<br />D ATE � 01"7 T! M E: C-
<br />CASF 9�
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<br />I-OCATION r. EN SPACE) (A) FiST �k . . ......
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<br />Naiiie, Ltisi First Middle D013: Race,,Sex-
<br />L F rZ, i) U-1 it (,C c5c 0.
<br />R.e,.;,,, Address: C'fty sftdce,,�, Plione� Work Phone:
<br />Zip R.
<br />--L-MR-AA -ST 1rL -T . .........
<br />Und er the authority of Ad minis trative Order No. 58-03-24-F and Park: and Open Space Ru le 1.005(3), you are hereby
<br />notified that you are prohibited From (check box):
<br />XEntering in or using all City of Eugene parks, open spaces or facilities.
<br />The basis fbr this Notice of Restriction of Use is that on -730 L-5- you violated Section c)f the Park
<br />9, q0 5 . . .... ......... Q . ......
<br />and Open Space Rules, and/or Section 1i of the. Eugene Code, 197 1, and/or ORSvrit,
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<br />_6-jV4 jif-56. I- (&ZtYE
<br />-DJT-f7(,'FC,-R2rz- WS7-H POL-r-ea-
<br />(Description of the violation.,)
<br />This restriction of use is efrective beginning onuntil 115"
<br />and s�hall remain in effect
<br />If you enter in or use any City of Eugene park, open space or facility during the effective period of this Nofice, you rnay be
<br />arrested and charged with criminal trespass in the ,second degree,
<br />Pursuant to Park. and Opu.rm Space Rule R-4.074 you are entitted to an. inf6mial hearing to contleist this Notict7.,. A reqijer,..A fi.)r an.
<br />informal licaring must be made in writing and filed with the Parks & Open Space Division Director ("the Division Direlclor", '
<br />within 48 hours (exclusive of weekends) of receipt of this Notice want the following address: 1820 Roosevelt, Blvd., Eugene, OR
<br />97402.
<br />The Division Directior shall schedule a tinie and place f6ir the informal hearing to be conducte(L M,6ch shall be niot more t1ran
<br />72 hours (exclusive of weekends) of receipt of the request for heaxing. At the informal hearing the Division Mrector will only
<br />consider testirriony from you, "ity personnel involved in theincident that resulted in. this Notice, and other witnesses tic) thic-
<br />inCident. The Division. Director may exclude anyione,, other than you and those presenting testirriony., fi-moin the into u-na I hearing,
<br />This Notice shall remain in effeet pending any requested hearing.
<br />This Notice c,& Exclusion was delivered to the person named at the top ofthis Np"> at the date and time.shown abiovie 1),Y:
<br />tf3,
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<br />(Sig ture csf'j1CT1,4M ISSI,drip
<br />,,/delivering notui
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above.
<br />4*�iff(?> 9LL,(-P,3 0140'r.
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<br />(Signaturie ofj-,Persa)n Weing issued the rwfkze4
<br />lik Cop! : Buckie' nrlf,;ro Gr,�,en(.'ojpy: He YeHow i Rejl,0 r,npy Tlm� Copy, Recipli'mki Gpc[d i i Apca[ noui,.,e O- 10
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