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NOTICE OF RESTRICTION OF USE <br />and Notice ofRight to Appeal <br />L <br />DATEI� C�- CASE <br />TIME: <br />LX)CATION (PARK,/0PENSPA(...'E): <br />- ------------- ----------- - - <br />NaineLast F-st Middle BOB: Rac SLX: <br />RcsA C te Plione. Work plwne� <br />L4A� <br />IL_ <br />Under theauthority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, experts aaees or facilities. <br />-.1-- — — - - - - ---------------------- -- ................................................................................................................................................................ . . . . . . . ---1---...— -- -,11 <br />The basis for this Notice of'Restrictii'm of Use is that on CafSecti <br />viol <br />,— you auxi on . . . . . . ................... ofthe Park <br />b .. . ....................... . - <br />and (Ven Space Rules, and/or Sectionq- - --+— ug <br />of the Eene Co 197 l�., an.d/oORS <br />�r fir,::, wit, viGu <br />---------------- . . .............. <br />--7 . .... . <br />........................................................... ..................................................................................................................................... . ..... . . <br />,(Description ofthe violation.) <br />This restriction of use is effective beginning on <br />_, and shall remain in effect until <br />If you enter in or use any City of Eugene park., open space: or facility during the effective period of tNs Notice, you rnay be <br />arrested and charged with criminal trespass in the second degree, <br />Pursuant to Parkund ('.)pen Space Rule R- 1 .074 you are entitled to air informal hearing to contest this Nioticic. A requestfi.,)r an <br />informal hearing must ble made in viriting and filed with the Parks & Open Space Division if ("Ible, I hvision <br />within 48 hours (exclusive of weekends) of receipt of thi% Notice at the following address: 1820 Roosevelt, Blvd., Eugene, )R <br />97402. <br />rhe Division Director shall schedule a tirne and place for the informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of'receipt of the request for hearing. At the infiminal hearing the Division Directic.ff wiH only <br />consider testitnony from you, City personnel involved in the incident that resulted in this 11'�utice, and otherwitnessies� [t) thee, <br />incident, The Division Director rnay exclude anyone, other than you and those presenting lestirnony, frorn the inR)rmal <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person narncd at the top ofthi. Not' -e at th <br />(),d', C_dWc and line shown above 1:nY: <br />...................... . ............ ........ . <br />(Signature ofperson issuing/delivering notice) <br />I liereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person l-.-,�eing issued the notice) <br />W11Rkr,: Copy: IPnublic rVDrk,,, GrcTn iC K,aPy: Fle Yellow Copy: Repcd C'cpy Nnk Cropy: Reciipiera�,JoH (..'�opy: (MiTtvir AppekiiiI nutl�urc kvv, 04 (t:'6 <br />