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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE � ....................................................................... . -- TIME�' CASE k. /Y-, 13c)f-11 <br />Is <br />LOCATION (PARKJOI.-IEN SPACE) <br />2A -.._e . ............ ....... . . ............ . ---------- ------------------- ------ - ---- -- ---------------------------- <br />N mme:: i ast First Middle DO, B Race/ <br />X <br />c,3 <br />ill Res, Phone' Work Phow- <br />W <br />lRes.r� I I <br />Under the authority of Administrative Order No. 58-03-24-17 and Park and Open. Space Rule R-1.005(3)., you are hereby <br />notified that you are prohibited frouk (check box): <br />41 <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />..... . .. . ................................. . .. . .. .. . .. . . . .................... . ... ....... . <br />The basis for this Notice of Restfictirm of Use is that, on 'S" yf�.)uviolated Slection J. 01t)te k <br />0 6Far <br />F <br />and Open Space Rules, and/or Section of the Eugene Code,. t 97 f, and/or 016 TO Wit, )f(JU: <br />........... <br />........... ..... <br />.............. <br />(Description of the violation') <br />and shall remain in effect undl__1 I <br />This restriction of use is effective beginning on .............. 4 <br />d -iA I <br />if y'oui enter- in or use tiny City of Eugene park, open space or facility during the effective period of this Notice, you rna.), be <br />arrested and charged widi criminal trespass in the second degree, <br />Pursuant to Park and Open Space Rule R- 1.074 you are entitled to an inflortnal hearing to contest this Notice. A requiest for ;.,m <br />inforITUd hearing inust be inade inwriting and filed with the Parks & Open Space Division Director ("'the Division Director") <br />within 48 hours (exclusive of weekends) of'reccipt of this Notice at the fol.lowing address: 1821) Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the int'ormal hearing to be condUcted, which shall ble, not more. t[ian <br />72 hours (exclusive of weekends) of receipt ofthe request for hearing. At the ir&nual hearing the 11'.)Msion Director will Gni,y <br />consider testimony frorn you, (. "ity personnel involved in the incident that resulted in. this Notice., and other witnesse,4 to the <br />incident, Division Director may exclude anyone, other than you and those presenting testimiony, From the infiormal heari ng.. <br />This Notice shall remain in effect pending any requested hearing. <br />']"his Notice of'Exclusion was delivered to thr person earn ed at the top ofthis Mantic at <br />----- - - - ----- . . . . ..... . ................. ...... . ....... —, .. ... .... ...... . ....... <br />(Sig anaature ot'pCT60f) iSSUring/delivering riut]CC <br />') ytc 's * ttaoi <br />I hereby acknowledge receipt of" tine above Notice on the date and time indicated above. <br />(Signature of persion issued thee noficnr�";) <br />'p Lie (:'c'p,: Pu b I i c W r,.,, rks rlrcervr,7opyHe Y e no W COPY! Report Cory PmCrpry 14.uipkml (k.61 (..:'rppyiDificer,kppeal maiwe, Hovv, 11JI111107, <br />