ooh ta <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: .;�, - / a TIME: ,��� �� CASE #: <br />LOCATION (PARK/OPEN SPACE): � q //,, q f+, I) r47 <br />H Name: as First <br />w � � <br />U <br />Res. Address: <br />�1 <br />14 z_p <br />ity State Zip Res. Phone: Work Phone: <br />............ .... �7Va A�oA,& <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 />V_7�_ <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 7 3°" � � you violated Section of the Park <br />and Open Space Rules, and/or Section `�' 7 of the Eugene Code, 1971, and/or ORS To wit, you: <br />o� <br />(Description of the violation.) <br />This restriction of use is effective beginning g nn�.ng on and shad, 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 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 the date and time shown above by: <br />(Signature of person issuing/delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />(Signature of person being issued the notice) <br />White Copy: Public works Green Copy: File Yellow Copy: Report Copy Fink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 44143 <br />