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NOTICE OF RFSTRICTION OF USE
<br />and Notice of Right to Appeal
<br />DATE. TIME: CAS E
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<br />LOCATION (PARKA)PEN SP CL)
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<br />Mane: 1,,as4 Mrst irk kace/sex.
<br />5 Ic—7
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<br />Re�', Address. City State 7ip Res. Mont.- Work Phone,�
<br />Under the authority of Ad ininistrative Order No. 58-03-24--F and Park and Open Space Rule, R- 1 .05(3), you are hereby
<br />rootified that y u are prohibited from (chcek boxI:
<br />Entering in or using all City of Eugene parks, open spaces or facilities.
<br />F*
<br />The basis trbr this Notice of Restriction. of LJse is that on. .. . ........... . —, you violated Section
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<br />ant the Park
<br />ug
<br />and Open Space Rules., and/or Section. of tile ene Code, 197 1, and/or ORS
<br />zmc)VaD nit
<br />(Description of the violation.)
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<br />This restriction (if use is effective beginningand shall remain in effect until
<br />Asn
<br />If you enter in or use any Clity of.Eugene park, open space or facility during the effective period of this Notice, You ra-,iy be
<br />arrested and charged with criminal trespass in the second degree,
<br />Pursuant to Park and Open Shalee Rule R-1.074 you are entitled to an informal lie,,,,aing to oontest, this Notice, A recjuc,,-�t an
<br />informal hearing must be ruade in writing and filed with the Parks & Open Space Di0sion Dire ewr i Division
<br />within 48 hours (exclusive M'weekends) of'receipt ofthis Noticeat the following address. 1820 Roosevelt, Blvd., Eugenie, OR
<br />97402.
<br />The Division Director shull scheduie a lime and place for the informal heuring to be conducted, which shall b(.-,,, not [110TC th'an
<br />72 hours (ext."lusive of)vockends) of'reccipt ofthe request f6r hearing. At the infim-nal. hearing the, Division Director will only
<br />consider lestimony fron'l ycm, City personnel involved in the incident that resulted in. this Notice, anid other, witnessic,,s to thic,
<br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, fron-i ffie intornial hcarin,gi
<br />This Notice shall remain in effect pending any, requested hearing.
<br />'This Notice of Exclusion was delivered to the person named at the top of this Notice at the dateand time shuiwn ahc,.,)ve, b.r,,,,,
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<br />(Signawre ofperson issw,.iing/dehvcring nam ice 'm
<br />I herebyacknowledge ra ceipi of the above Notice on the (,late and time indicated above,
<br />14'h ae C'opyr PL&hC Vio'w ks (:irecn,t npyHilar Yet lo w 0 p y, R v. po n C: o py Pink Copy! Ret ,,iipwn1 a': old ( 'o py! 11) M ve, r A jppeI in a It ;'c- Kt,,,,, ( ) G 103
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