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7 <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />C <br />L-11- .......... . ... --- 'T, <br />DATE: TMME� CASE ft� 11l 3 10 1 <br />m...... . . ..... 1.5 .......... .......... . . <br />. . . ....................................... . . . . . .. <br />11 OCATION (PARKOPEN SP,NCE ........... ........ . . . . ...... ................... <br />Under the an tho rity of Ad uninis I rative Order No. 58-03-24- F and Pnark and Open Space Rule R.- 1 .005(3), you aire heriphy <br />notified that you are prohibitedfroni (check box), <br />Entering in or using all City of Eugene parks, open spaces or facilities, <br />10 <br />I <br />The basis for this Notice (,)fRestr'ction of Use is <br />that on - �rl 3 1- <br />1 <br />you violated of the, P.jrk <br />1 Section I,, <br />and Open Space Rules, andlor Section r ............... <br />of the Eugetie Code, <br />1971, <br />and/or ORS <br />T10 Wit, YIDILC. . . ....... . ..... <br />AA,611 -V A i <br />nc,..)71��7.jrll <br />(Description of the violatiork.) <br />This restriction of use is effective beginning on i and shall remain in effect until <br />1:11!20 -... LL -- <br />if you enter in or ust, any City of Eugene park, open space oy, fijCilityr during the eff�ctive pc6od o1r"this Notice, yoiu 1113, y be <br />arrested and charged with criminal trespass in the second degree, <br />Pursuant to Park and Open Space f�,.ule R 1 J)74 you are entitled to an informal hearing to contest this Notice, A rpt que,sit 16r art <br />inl6rnial hearing inust be niade in writing and filed with the Parks & Open Space Division Director ii. -the [.)ivisiorDiriector") <br />within 48 hours (exclusive (if weekends) of receipt of'thls Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />'Tbe Division Director shall schedule a time and place f.or the informal hearing to be conducted, which shall be ncr,4 more thark <br />72 hours (cjcclu&1e of weekends) of receipt of the request for hearing. At the inflDTIMI bearing the Diviskni Director will only <br />consider testimony frmn you, City person.n.el involved in the incident that resulted an this Notice, and ()thew-- witnesses io the <br />hicident. The Divisk,.sn Director may exc lude anyone, other than you and those presenting fl esti fi-oni. the inforrna� hicnill' U19, <br />This Notice shall remain in effcTt pending any requested hearing. <br />rl 'his Notice, of Exclusion was delivered to the person named at the top of this Nod tinie shown above b.y� <br />(SignaturAW'person issuing/delivering nioticc) <br />I hereby ack.nowledge receipt ofthe alto vc Notice on the date and time indicated <br />0, <br />... . . . . ............. . . . ............................... . ... . ........ .. ... . . . . ................................... <br />(Signature of person being issued the uto iue,F <br />Wllitc4opy Pubhf.`NV'JX&5 Gr"n Copy: He, YeHow Copy� ROJM1 C. Op.ry Pink Recjtmw Gold C'�-qry! Ajppmohirr,6�z(, Rev, 1.4'03 <br />