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NO'FICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: I'l M E� CASE k: <br />-5tKTY' <br />I...,OC'A'Tl(.),N(PAR,.KJOPENSII,A("'E)�: hk.X-0,4, L <br />Name: Last First Middle DOB.- Race/Sex: <br />(—V-A 145 <br />. ...... ......................... <br />(jt�' <br />ta V Res. Phone: Work PhoII <br />7ire- L -A17 *:0 <br />"L , . ........... <br />R", Addrm,< t- ip <br />Under tire authority ol'Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1 005(3), you are hereby <br />notified that you are prohibited from (ebeck, -box)- <br />Entering in or, using all City of Eugene parks, open spaces or facilities. <br />. .......... — ------------ . ............................. . . . . . .................. . . . . . . ........ . . . . . . . ....................................................................... . . . <br />The basis for this Notice of Restriction of Use is that on you violaled Section �e., I Park <br />......... . . ............................................................................ . . . . . . . . . ........... ........... .1 .................. <br />and Open Space Rules, and/or Section i,')fthic E'ugene Code, 197 , and/or ORS .. .... . .. . ........ . TO Y"it, Y011"r— <br />........ . ...... . ........ I., ...... ............. ........ ............ <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain irk effect until <br />If you enter in or use any City of Eugene park, open space or facility during the effective period oflhLs, Notice, you rnay be <br />arrested and charged with. cr4ninal. trespass in the second degree. <br />Pursuant to Park and. 0pen Space Rule R. -I.074 youare entitled to an inforrnal hearing to contest this Notice. A requiu sil. l'i'ra'.an <br />inf'orrnal hearing inust be inade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />%,ilhin 48 hours (eXCIUSIVC, ol'weekIeuds) of receipt of this Notice at the following address:: 1820 Roosevelt, Blvd., Eugeirkle, (..)'R <br />97402. <br />The Division Director shall schedule as tirne and place for the infornial hearing to be condrioed, which shall be not more than <br />72 flours (exclusive ol'weekends) of reccipt of the request for hearing, At th ' e a <br />intorml hearing the I)Msion Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice% and othior wftnie,.iscs to the <br />incident. The Division Director may excludeanyone, other than you and tbose rvesentinr testimony, frforn the infunnai huann,g <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 grand. tirne shomin abo�velby; <br />3ir",P <br />...................................................... ................................................ <br />(Signature of person issuing/defivering no,61cio) <br />I bereby acknowledge receipt ofthe above Notice on the date and tirne indicated above. <br />.......... <br />f kirce <br />Agnature )i perso ing i R btl't'v <br />A'144et Copy PublIv Work;, (X'Iroun Copy'6'& Y"JIo"V '(. up Repod, Copy Pink I ReJponl ',3olld F'Dpy�DIITNKCF.T. (11.ppvall Roilkrr'ir' . IrM/03 <br />