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NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE� CASE <br />I-, ........... 11 . . . .............. - ----- . . . . .......... . ................ . . . . ............. . ......... . ..... . . . . . .. . ................... . <br />LOCATION (PARK/OPEN SPACE): C <br />. . . ....... ------ ...... . ....... . <br />Nanic- La rst Middle DOB: Rasp <br />c/'S <br />2 <br />. ............ . . <br />Res. Add lZej— f1hugg— Wod,,,—Phone� <br />Under the authority of Administrative Order No. 58-03-24-Fand Park and Open Space Rule 11-1.005(3), ouareherehv <br />nolified that you are prohibited from (check box): <br />rEntering in or using all City of Eugene parks, open spaces or facilities. <br />'The basis for this Notice of Restriction of Use is that on o -�J—I el v:5 ., you violated Section 1. afthe Park <br />and Open Space Rules., and/or Section of the Eugene Code, 197 1, and/or ORS To Wit, yow <br />. ........ . . .................... . . . ..... ................ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and all remain in effect until <br />. . ....... <br />if you enter in or use any City of Eugene park, open space or facility during the effixfive period of this Notice, you. may be <br />arrested and charged %vith criminal trespass in thesecond degree. <br />Pursuant to Park and Open Space Rule R-1.074you are entitled to an informal hearing to contest this Notice, A request fir an <br />informal hearing, must be made in writing and filed with the Parks & Open Space Division Director ("the Divisiori. Director-) <br />within 48 hours (exclusive of weekends) of receipt ofthis Notice at the following address, 1820 Roosevelt, Blvd., Eugene, OR <br />97402, <br />The Division Director shall schedule a time and place for the infornial hearing to be conducted, which shall be riot niore than <br />72 hours (exclusive or weekends ' ) of receipt of the request for hearin& At the informal hearing the Division Denis. <br />Director wdl <br />consider testiy.ywny from you, (.,Ily personnel involved in the incident that resulted in this Notice, and other witnesses to <br />incident. The Division Director may exclude anyone, other ftan, you and those presenting testiniony, fi-om the informal hearing. <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 date and time shown abovie, by: <br />-P 7 - <br />.............. . . 1-11, . .................. . .............. . -. ... ... . ......... . . j. ...... ... . ............. . ...... 5 <br />(SignatUrC of person issuing/de i e ring notice) <br />t hereby acknowledge receipt of the above Notice (in the date and time indicated above. <br />.... . . . ............. <br />(Signature off)el,50u il.,, <br />1,g'IS'N,xed the notice) <br />Copy: Pell' lka wqmb (Jrr.%�r ir,'npy: Fifle Yellow Copy: RepuTt Copy (..'opyR4xipwm CAI Cupy, Of .e'r Apperd rtoflcc. IR ev, <br />