l ��,a (o cv4"') <br />NOTICE OF RESTRICTION OF USE <br />DATE: 0 I _�_o [I <br />and Notice of Right to Appeal <br />i z - 6 L-4-93 C D-�) <br />TIME: ' 4 �J 2- CASE #: l _ (3 <br />LOCATION (PARK/OPEN SPACE): tl'I ay_ <br />z <br />w <br />Name: Last First p addle <br />I- I f RSCJ - t WA \t N C,' A Ivr <br />DOB: <br />4 6U <br />Race /$ex: <br />61 <br />a <br />�_J( <br />U <br />Res. Address: City <br />State <br />Zip <br />Res. Phone: <br />Work Phone: <br />W 0 kke L-�`S S <br />LA 6 <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 OG O L'� t12 , you violated Section 1, 0 C b of the Park <br />and Open Space Rules, and/or Section of the Eugene Code, 1971, and/or ORS To wit, you: <br />V1 0 L, T QQA ( Dr - TA aV_ ZLI,t, LC S 0 5 6 U T MAYk A <br />(Description of the violation.) <br />This restriction of use is effective beginning on �� b t L 2 , and shall remain in effect until 0 1 1( 1 ) l 1 - 2 <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 e informal hearing to be conducted, which shall be not more than <br />72 hours (exclusive of weekends) of receipt of the request f hearing. At the informal hearing the Division Director will only <br />consider testimony from you, City personnel involved in the ' cident that resulted in this Notice, and ther witnesses to the <br />incident. The Division Director may exclude anyone, other than on and those presenting testimony,, frj the informal hearing. <br />This Notice shall remain in effect pending any requested hea 'ng. <br />This Notice of Exclusion was delivered to the person named at the tl p of Notice at tWdate a& time shown above by: <br />of person issuing /delivering notice) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />� G <br />(Signs of per An being issued the notice) <br />to Copy: Public Works Green Copy: File Yellow Copy: Report Copy Pink Copy: Recipient Gold Copy: Officer Appeal notice Rev. 04/03 <br />