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Vp <br />NOTICLtOF k OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: 12 33 CASE #: f 2 <br />LOCATION (PARK/OPEN SPACE): P� tzC. <br />Natne: Last First Middle DDB: Race/ ex: <br />ALEkAg Li v p c�. r 1 1 P� rwao <br />Res. Address: City State Zip Res. Phone: Work Phone: <br />256 M <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 />. . . X <br />El <br />The basis for this Notice of Restriction of Use is that on <br />U ou violated Section y of the Park <br />and en Space Rules, and/or Section , of the Eugene Code • <br />p p � g , 1.97 I , and/or ORS To wit, y ou. <br />lav hi <br />(Description of the violation.) <br />This restriction of use is effective beginning on • <br />g g , and shall remain in effect until <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 fixed 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 onl <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 the date and time shown above by: <br />(SiTnature of person issuing /delivering notice) <br />l hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />P gnatuYe of person being issued the notice) <br />My: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy; Officer Appeal notice Rev. 44103 <br />