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DATE: 07 S ) ZO )2 <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />TIME: I :,3 l7 PM <br />31 <br />CASE #: ' L — , 0 - 7;3 — <br />LOCATION (PARK/OPEN SPACE): (/ -r44 WAS4 1 N 4 TON <br />z <br />w <br />Name: Last � First „�4 Mt 6 <br />�� <br />DOB: <br />` Q <br />Ra / ^e <br />'VIVU <br />W <br />Res. A ess: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />o C- LASS <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 />The basis for this Notice of Restriction of Use is that on /T J 112 , you violated Section l ' b b of the Park <br />f ' r <br />and Open Space Rules, and/or Section `T) b TO of the Eugene Code, 1971, and/or ORS To wit, you: <br />VIOLINTION PAR� RULC-S - - POSIVCM - 0 AL cC44 OL <br />(Description of the violation.) <br />This restriction of use is effective beginning on 07311 , and shall remain in effect until OM I 1 <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 Not' at t d time shown above by: <br />Z <br />(Signature of person issuing /delivering notice) <br />we Notice on the date and time inda4 n <br />being issue he notice) <br />White <br />Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice <br />Rev. 04/03 <br />