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NOTICE OF IlEs"rRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE:I C,� (::::�C t �O
<br />Timf-,� 6 CASE 4.
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<br />LOCATION (PARK/ 0PEN SP,A(,'E)-,
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<br />Name: L,a,,,4 F" -t Middic DOB: kaco/sex-
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<br />R",, As: L'4y statPhon
<br />e Zip Res. e: WcirkPhone
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<br />Under the authority of Administrative Order No. 58-03-244 and Park and Open Space Rule R L005(3), you are hereby
<br />notified that you are prohibited from (check box):
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
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<br />The basis forthis Notice of Restriction of Use is that onyou vio�lated Section of Park,
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<br />,%q, -�
<br />and Open Space Rules, and/or Section of t he Eugene ("ode, 1971., and/or ORS 1,0 wit, yoli:
<br />)T51
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<br />(Description ofthe violation.)
<br />This restriction ref u se is effective beginning o n0 C�Vo .and shall remain in effect Until
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<br />If you enter in or use any (,'..ity of D.igene park, open space or facility during the effective period of this Notice, you may hive
<br />arrested and charged wi fli cri ruinal trespass in the second degree.
<br />Pursuant to Park and Open Spacc Rule R-1.07 you are entitled to an informal hearing to contest this Notice. A request 6or an
<br />informal bearing must be rn,ade in writing and filed with the Parks & Open Space Division. ffirectur ("the Division l3ireebor")
<br />within 48 hours (exclusive of weekends') of receipt ofthis Notice at the follaxvingaddress:: 1820 Roosevelt, Blvd., Eugene, OR
<br />97402.
<br />The Division Director shall schedule as time and place for the informal hearing to be conducted, which shall be not, moric than
<br />72 hours (exclusive of weekends) of receipt of the request for hearing. At the informal hearing the Division Director NviH only
<br />consider testirriony from you, City personnel involved in the incident that resulted in this Notice, and othi,,,-r witriessirs, to khe
<br />incident. The Division Director rnay excludeanyone, other than you and fliose presenting tesfimonY, firorri the int'ornial %iiunjring,
<br />This Notice shall remain in effect pending any requested hearing.
<br />This Notiec of Excluslon was delivered to the perw�n name�.J at the top of this Notice at the abate: and firrw shownabove by-
<br />...... ...... ........
<br />(Sigtian,ire ofiq u
<br />person s /i delivering nofice,t
<br />I hereby acknowledge receipt of the above Notice on the date and time indicated above,
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<br />�Signature of permy
<br />Whilc Copw Pullifir.., Wcvrk,� is opy: Hv YF.'Uow Ucnpy! Rqxnl Cupy Runk Copy, Recipient Gold rr'opy! nnkcr A,.ppca,1 noliicc� Frey 0,V03
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