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NOTICE OF RESTRICTION OF USE <br />. 3 <br />DATE, <br />and Notice of Right to Appeal <br />8, <br />0- IS <br />- <br />TIME: CASE #: <br />LOCATION (PARY&OPEN SPACE): <br />t - <br />Natnejast I <br />F' st <br />diddle <br />DOB: <br />Ra C <br />44 , AJ <br />Res. Address: <br />o C C ity t <br />R2 <br />Work Phone. <br />6111 U e__ <br />1 J <br />1 <br />Under the authority of AdrniriistrativlderNo. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby <br />0 Entering in or using all City of Eugene parks, open spaces or facilities, <br />V <br />(Description of the violation.) <br />This restriction of use is effective beginning on and shall remain in effect until <br />If you enter in or use any City of Eugene park, open space or flicility 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-I .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 fbIlowing address: 1820 Roosevelt, Blvd., Eugene, OR <br />97402. <br />M "'VCkCHUS) VJ_1C4,V1VL 91 UIF_ I VqUUNL 1*1 AlUallllg, PU UIC H-FiV1111di !Wdrulg UIC <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 <br />I hereby acknowledge receipt of the above Notice on the date and time indicated <br />No <br />0 <br />of person being issued the notice <br />and time shoo m above by <br />i issuing/delivering notice) <br />White Copy: Public Works GreenCopC File Yellow Copy: Report Copy Pink Copy: Recipient Gold C opy r Officer Appeal notice Rev. 04/03 <br />