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r <br />r <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: 1 z, TIME: 1 it. CASE #: <br />LOCATION (PARK/OPEN SPACE): Odf,c✓Zc,j c/�1 dJ ST �gJ2J� <br />z <br />Name: Lilst <br />F4stj Middle <br />DOP: _ <br />Race /Sex: <br />W <br />r fc�z <br />U <br />Res. Address: <br />City <br />I Z' <br />Res <br />Work Phone: <br />�$%tte <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 />Entering in or using all City of Eugene parks, open spaces or facilities. <br />(rWr J <br />The basis for this Notice of Restriction of Use is that on 0'6 you violated Section of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />�: v � f�„'LN,I�- ►--rep( -✓� <br />- . <br />_(Description <br />This restricti f <br />ie violation.) <br />of use is effective beginning on , and shall remain in effect until j 12 . <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 for 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. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at th date and time shown above by: <br />(Signs, person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time in <br />Wltite Copy: Public Works Grem, Copy:, File' Yellow Copy: Report Copy. Pink Copy: Recipient <br />d above. <br />t�, "o 1 <br />(Signature of person being issued the notice) <br />Gold Copy Officer Appeal notice Rev. <br />,l <br />