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NOTICE OF RESTRICTION OF USE <br />and Nonce of Right to Appeal <br />DATE: 0 zo- TIME: 07SM3 CASE #: J4? "' 6+7 2W <br />LOCATION (PARK/OPEN SPACE): &1A Lf /,f 7, lot -r <br />�. <br />Name: Last First Middle <br />L e W Z ;S <br />DOB: <br />Race /Se , <br />.0 <br />0 <br />Res, Address: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />v_ ;9 w i 1 2! 'YAW <br />j 0 <br />1 97 �bl <br />Under the authority of 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 (check box): <br />�7 <br />Entering n or usi all C of Eu arks, open aces or facilities. <br />g g �' � p P p <br />d <br />The basis for this Notice of Restriction of Use is that ono you violated Section 4 *0/,7 of the Park <br />and Open Space Rules, and/or Section y* 70Z of the Eugene Code, 1971, and/or ORS To wit, you: <br />/,X 3) <br />%me or <br />(Description of the violation.) <br />This restriction of use is effective beginning on 49 / 1 Zw ,and shall remain in effect until a .52S / 2 <br />If you enter in or use any City of Eugene park, open space or facility during the effective Teriod 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 for an <br />informal hearing must -be made in writing and fi led 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: 1.820 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 shad remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the'top of this N , tice at the date and time shown above by: <br />5&6" #J 7" eAvt*4VPJ <br />(Signature of person issuing/delivering notice) <br />i hereby adknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of persV being is ued the notice) <br />l� <br />7 <br />White Copy: Public Works Grcen Copy; File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: officer Appeal notice Rev. 04/03 <br />