NOTICE OF RESTRICTION OF USE <br />and Notice ofRight to Appeal <br />DATE:: TIME� 57," CASE <br />k-OCATION (PARKOPEN SPACE): SWJ�JPr-6 .13Vr7` <br />Nanic: Last Firvt Middle DOW JR acc/sex: <br />Lj <br />D6YJ SCA- <br />Rcs� Address: <br />C,ity State Zip Rcs. Nione: Wolk <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-11.005(3 , you are hereby <br />notified that you are prohibited from (check box): <br />0 Entering in or using all City of Eugene parks, (open spaces or facilities. <br />............................................................ ........... . . . ......................... . ...... . . ......... . ... <br />0 6 �,4 <br />The basis for this Notice ol"Restriction of Use is that --,you violated Section. - P a rk <br />and Open Space Rules, andlor Section �11 2A(0ofthe Eugene Code, 19'71,, and/or OKS ° To wit., y0U,:­.­­.__..._ <br />-------------- - ----------- <br />0 UV,4J 10 <br />W6' PA(Z C -,r , <br />(Description of the vio I at ion. <br />This restriction of use is effective beginnin.g on and shall remain in effect until <br />If you enter in or use any City of Eugene park, opcn space or facility during the effective period of this M.)tiue, y1ou rnay be <br />arrested and charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Rule R 1.074 you are entitledto art inf6rmal. hearing to contest this M.Aicxrequestfor airy. <br />informal hearing must be made in writing and filed with the Parks, & Open Space Division Director ("the Division Director",) <br />within 48 hours (exclusive ol'wockends) of receipt ofthis Notice, at the fol lowing address; 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shaill schedule as thane- and place for the informal hearing to be conducted, which shall ble rrot rnorr, than <br />72 hours (exclusivie of weekends) of receipt of the request for hearing. At the inforrrual hearing the Division Director will only <br />DMISider testiniony from you, City personnel involved irk the incident that resulted in this Notice., and other witnies..;rst,�s tru the, <br />incident. The Division Director may exclude anyone, other than you and those presenting testfinony, firorn flu.,� infornial. hearing. <br />This Notice shall remain in efftTt pending any requested hearing. <br />This Notice of Exclusion was delivered to the person narned at the top of this Notice at the data: and fitne shown above by� <br />_77 <br />(Signature ofperson iss;uing/dial ivLring; pnoyj� <br />I hereby acknowledge mcc,,ipt ofthe above Notice on the date and tirne indicated abt-we. <br />(Signature ofperson being issued the notree) <br />Wh le r,_'opy Vuhfic Worb, Ciruna C'opy: Fift, Y fA Gi.vx Cc, py: Report Copy Pink Cupy� lUxiplcnr Gold Cupy:offilcvr A.Px d R v v U4 11 0 <br />