ql <br />NOTICE OF RESTRICTION OF USEI S-- 1,5-/ <br />and Notice of Right to Appeal <br /># <br />5' T 1.�Ivl E <br />DATE. / CASE P: <br />LOCATKI )N (PARK/OPEN SPACE):_,,__ .................. . . . . ................ . . ....... .......... <br />. . ............. <br />Namc- 1.11j,"t t-irst Middle DOH. <br />A 6 1, fA G -Ill <br />res'8: Cit. <br />Rcs, A Y State W`ork Tlhorle� <br />? <br />Under the authority of Administrative Order No. 58-03-24-Fand Park and Open Space Rule R-1.005(3), you are hereby <br />notifted that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, open spaces or facilities. <br />El... ........... . ........... . . . . . . . . . . .......... . .. ............................. . . . . . . . . . . . . . ........... . . --- ..................................... . . - <br />'The basis for this Notice of"llestriction of LNe is that ori, you violated Sectkm of the Park <br />and Open Space Rules, andCr Sec6o-n.--1—,1.---- ofthe Eugene Code, 197 L, and/cir O.R.S ............ . . - --------- - ------ To Wil" YOU . . ........ <br />LLo:j.........1...111:�� I . <br />. ..... . --.11 . . ....... ---..... . ........... . . ...1-1— — .1... <br />1--- . . .................. .. . . . . ...... . . <br />........................ ... .......... <br />(Description of tfie viclatiori.) <br />is restriction of use is effective beginning on <br />V / `--5 ands remain in effect until <br />... .... ......... . . . I -- ........... . ... . .... — <br />Ifyou enter in or use any City of 17,ugene park, open spiace or facility durinP7 the e4fecfivu:, pc6od ofthis Notice, you may be <br />arrested and charged with criminal trLspiass in the second degree. <br />Pursuant to Park and Open Space Rule 1i-1.074 you arc entitled tcan inl'onnal hearing to contesll this t° oto A request fc,ur an <br />informal hearing must be made inwriting and filed with the Parks & Open Space Division Director ("'the Division Director-) <br />within 48 hours (exclusive of'weekends) ofreceipt of this Notice at the followingaddress: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />The Division Director shall schedule a time and place for the in 11ornial hearing to be conducted, which shall be not mcwc than <br />72 hours (exclusive ofweckends) of'reecipt of the request fbr hearing,, At the inforr'nal hearing the Division Director will only <br />consider testimony frorn you, City personnel involved in the incident that resulted in this Notice, and other ,vitnesrsi4.',,s, to the <br />incident.'The Division i . )irector may exclude anyone, other than you and those presenting testimony, from, the irifcnmal hearing, <br />'rhis Notice shall remain in effect pending ,my requested hearing. 4 <br />This Notice of l"Aclusion was delivered to the person named at the top of this Notice at IXe date and time shown above by� <br />f hereby acknowledge receipt of the above Notice on the date and time <br />ot'person issuing/dehvering notive) <br />above. <br />y. <br />----------- . . ......... . . . .... . . . . ......................... . . . . . .. .................. . . <br />(Signature of person t'"a <br />tnsad t1ilie, noticie) <br />Whil,t, Copy! Puhfic Wovk Filk: Yellow Cupy; R.epori COPY Pink (-'opy: KcciPk-.r11 GoIld (.'opy. I AppfnuP FIONI.!L, Ke,, iftaP03 <br />