GCPD-21 Rev. 2
05-Apr-2018
PARKING VIOLATION REQUEST FOR HEARING
I hereby request a hearing to appeal a parking summons:
DATE:____________
NAME:_______________________________________________
ADDRESS:____________________________________________
CITY/TOWN/STATE/ZIP:________________________________
EMAIL:_______________________________________________
PHONE:_______________________________________________
STATE & LICENSE PLATE:______________________________
TICKET NUMBER:_____________TICKET DATE:_____________
________________________________________________________________
Please provide your reason for the appeal below:
SIGNATURE:____________________________________________
Pursuant to Ordinance #215 “An Ordinance Establishing Parking Regulations in the City
of Groton” a Hearing will take place on
___________________________@____________________ at the Municipal Building,
295 Meridian Street, Groton, CT. Both sides of this matter will be heard at that time.
IF YOU ARE UNABLE TO KEEP YOUR APPOINTMENT PLEASE CALL
(860) 446-4102 IN ORDER TO AVOID FORFEITING YOUR RIGHT TO APPEAL.
THE CHIEF HEARING OFFICER SHALL GRANT CONTINUANCE UPON GOOD
CAUSE SHOWN.
CITY OF GROTON
295 Meridian Street
Groton, CT 06340
Telephone: (860)446-4102
Fax: (860)446-4109
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