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Notice Of Administrative Citation Appeal And Request For Hearing - City Of Long Beach

NOTICE OF ADMINISTRATIVE CITATION APPEAL

AND

REQUEST FOR HEARING

City of Long Beach

Department of Community Development

Neighborhood Services Bureau

333 W. Ocean Blvd, 3

Floor

Long Beach, CA 90802

I _________________________________, am requesting an Appeal Hearing regarding

(Print Name of Cited Party/Appellant)

Administrative Citation Number_______________, issued to me on ________________

(Print Citation No.)

(Print Date of Citation)

regarding property located at __________________________________________ in the

(Print Address where Violation Occurred)

City of Long Beach, State of California. It is my desire to contest this citation based on the

following grounds: (check each appropriate box)

I am not the responsible party for the cited violation(s).

The cited violation(s) did not exist on the date the citation was issued.

I understand the hearing on appeal is limited to relevant evidence only as to those grounds

indicated above. I declare under penalty of perjury that the foregoing is true and correct.

Notice Of Administrative Citation Appeal And Request For Hearing - City Of Long Beach