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NOTICE OF RESTRICTION CSF JJSE
<br />and Notice of Right to Appeal
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<br />LOCATION (PAR KJOPEN SPA(.'E) Alu
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<br />lqameUrist Firsn Middle DOB:
<br />-ae 4-9 co is:
<br />Res. A,ddress-, C.,ity 'pit �a't =eZ- i P I Res. Phonc: Work Phone:
<br />Under the authority of Administrative Order No. -03-24-F' and Park and Open' pace Rule R-1.005(3), you. are her iebly
<br />notified that you are prohibited from (check box) -
<br />k Entering in or using all City of Eugene parks, opens rices or facilities.
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<br />The basis for this Notice of Restriction �of Use is that on - youviolatedSeiction JILL� o 'le
<br />9.tr- , f 11 '. Park
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<br />a nd Open Space Rul c s, andtor Section of the Eugene Code, 1X71„ and/or 0 RS To wit,
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<br />(Description of the violation.)
<br />This restriction of use is effective beginning on and shall remain in effeettinfil -4�-L('ts ......... . . . . . .
<br />If you enter in or use any City of Eugene park., open space or facility during the effective period of this Notilele, you 11,tay ble
<br />arrested and charged with criminal tresp.ass, in the second degree,
<br />Pursuant to Park and Open Spaice Rule R-1 .074 you are entitled to an inf6rrnal hearinj to contest this Notice. A filir an
<br />intbrmal hearing must be made inn writing and Filed with the Parks &. Open Space Division Director ("the Division Diriectir,,�T")
<br />within 48 hours (exclusivc of weekends) ol'reccipt ofihis Noticeat the following addrcs:;: 1820 Roosevelt, Blvd, Eugene, OR
<br />97402.
<br />The Divisloii Director shall schedule a time and place fior the informal hearing to be corinducted, which ;hall be not u,rrorc than
<br />72 hours (exclUSi VC of weekends) ofrecc,,ipt of the request f6r hearing. At the informal h..-aring the Division Director will ordy.
<br />consider testinwiny filairn you., ("..'ity personnel involved in the incident that resulted in. this Notice, and other witnesses [o thic
<br />incident, The Division Dimctor may exclude wiyone, other than you and those presenting testimony, frcnn the infi.x-rnal hu.-,arn,r,g,
<br />This; Notice shall reniam in effect pending any requested hearing,,
<br />This Notice of Exchasion was delivered to the person manned at the top ofthis Notice at the diate and time shown above by�
<br />A44S r ,
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<br />(Signalure of 1:w.rson
<br />I hereby ackniowliedge receipt Of the above Notice kin the data; and time indicated above.
<br />(Signature ofpersion being IIssu.neid this nicjkcr,,,P,.1
<br />Whille Colpy: PL&14: Wuuks (3 R t.,, E., n Cc, p,,, ' F � I r "rNAllow Copy� R.qxwl ( oqry Nnk. Copy: Recipjo,RL Cjukl rr!iopy: Crgbcor Apped nrr�6crr�� Rre,�, 0,01,
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