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e 5��NOTICE OF RESTRICTION OF USE <br />and Noticc of Right to Appqal <br />DATL . . ............. . ..... . TIME: , p -- (3 <br />--J-q�-,t - ----- -- CASE #: - 3t( - ------ -- <br />LOCATION (PARK/OPEN SPACE' (3 <br />&A0 ?. k: . ............ . . . ..... - - -6. a a I I .......... - ...... . . . ...................... .. . . .................. . . . . .... . <br />Narne: Last First MiWe DOW <br />Rei-j�Jdress� City StateZip Res. Phony Wk.)r1( PhOflC� <br />L . . . ....... <br />Under the authority of Administrutive Order No. 58-03-24-F and Park and Open Spate Rule R-1.005(3), you are hipreby <br />notified that you are prohibited from (check box): <br />)4— Entering In or using all City of Eugene parks, open spaces or facilities. <br />(011 <br />The basis for this Notice ofRe.striiction of'Use is that on you violated Section /r of Che PE6�r, <br />and Open Space Rules, and/ort Section--- . ofthe Eugene Code, 1.971, and/or ORS I --- ---------- 1—� Tol wit, yiulx° . .................. . ......... . <br />(Description of the Violationj <br />I si S --- <br />'['his restriction of use is effective beginning on —AL -W <br />ll` you enter in or usea any City of Eugene park-, open space or facility during the effective period of this Notice, you may be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R- 1,074 you are entitled to an informal hearing to contest thfis Notice, A requcsi l'or tan <br />inflorrnal. hearing, triust be made in writing and filed with the Parks &- Open Space Division I )irector ("the Division DirecmC') <br />Mthin 48 hours (exclusive ofweekends) of receipt ofthis, Notice at the following address; 1820 Roosevelt, Blvd., Fugene, OR <br />97402. <br />The Division Directur shall schedule a time and place for the informal hearing to be (..;onductcd, which sliall be riot rnore th,,,m <br />72 hours (exclusive of weekends') of receipt ot'thc request for hearing. At the informal hearing the Division Director will only <br />consider testimony from you, ( ."ity personnel involved in the incident that resultcd in this Notice, and other witnesses to t-he� <br />incident. The Division Direclor rrvay exclude anyone, other than. you an(] those presenting testimony, fi-lorn the informal hearinf,. <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exchsic-)n was delivered to the person named at the top of this <br />I hereby acknowledge receipt of the above Noficc on the date and time <br />M <br />the dote and firne shoqxn above lay: <br />. .. .... ....... . .... . . .............. . I ........ . . . <br />D �Vr rPee <br />rsOn TSSUin� /delivering noticie) <br />above, <br />being issued the noficir) <br />Whau (Aipy: iPiublic WoAs (J,ruen rr.:opy. IHe Y'c1hrw CupyReparl iPolpy Pink Recip%:uit CoM 4'rpy: Offj,ccr Apjp-,,,kP nrrrdce ke,, <br />