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s140,� 15z�35 <br />NOTICE OF RESTRICTION OF USE <br />a r� and Notice of Right to Appeal <br />DATE: _ [� O d� � TIME: d 1 !T-3 CASE <br />LOCATION (PARK/OPEN SPAC E): tN �—L— S j T r .L�(- <br />L <br />Vie: Last <br />rsi Middl . <br />17038: <br />Rte 'S X: <br />s: <br />W�7cp <br />^� its° <br />Stattye. <br />7i <br />Res. Phone: <br />Work Phone: <br />Under the authority of Administrative 0rde.r No. 58-03-24-F and Park and Open Spare. Rule R-1.005(3), you are hereby <br />notified that you are prohibited Froin (check box): <br />ntering in or using a rty of cilities. <br />l_t TE_jZT-&)b nQu&=.)b W l-TPA-2IL a( s <br />The basis for this Notice of Restriction of Use is that on 0 � d -5-I , you violated Section of the Park <br />and Opejt Space Rules, and/or Section of the Eugene Code, 1971, and/or DRS To wit, you: <br />(Description of the violation.) <br />This restriction of use is effective beginning on 01901S /r , and shall remain in effect until 09 „21C Sr <br />If you enter in or use any City of Eugene park, open space or facility during the effective Period of this Notice, you may 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 entitled to an informal hearing to contest this Notice, A request far an <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 of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time 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 informal hearing the. Division Director will only <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing. <br />This Notice ;shall remain in effect pending any requested hearing. r <br />This Notice of Exclusion was delivered to the person named at the top of this Ne at the date antime shown above by: <br />qj <br />l.S. a re of]?c.rson issuingidclivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time <br />(Signature of person being issued the notice) <br />White Copy: Public Works Green Copy: Pile Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Ofricer Appeal notice Rev 04/03 <br />