FORM II: CIVIL CITATION FORM.
For a printer-friendly, PDF version, click: Form II
   The notice of violation may specify a period during which the violator must correct the violation. If the violation is not corrected within the specific time, the violator shall be guilty of a new and separate offense.
CITY OF LINCOLNTON
FIRE PREVENTION AND PROTECTION ORDINANCE
CIVIL CITATION
The following civil citation is hereby issued to:
Name: ____________________________________________________________________________
Address: __________________________________________________________________________
Occupancy: ________________________________________________________________________
Vehicle License #: __________________________________________________________________
Place of violation: __________________________________________________________________
Date: ___________________________ Time: __________________________________________
You are in violation of Section (s) _____________________________________________________
_________________________________________________________________________________
in that (describe acts, omissions, or conditions which constitute violation):
This citation is issued for a violation which occurred or existed on _________________ at the following location:____________________________________________ and was investigated by: _____________________________________ Title: _________________________.
This violation(s) subjects you to a civil penalty in the amount of $ _____________ which must be paid within 30 days. If this penalty is not paid within 30 days of the date and time shown below, a delinquency charge of $10 will be added. A criminal summons or warrant may be issued if the penalty plus delinquency charge are not paid within 5 days after the date of the delinquency notice.
Penalty continues at $ __________ per day until the violation (s) have corrected.
This citation, was issued at __________ (a.m.) (p.m.), the ______ day of __________, _______,
and must be paid at the Fire Marshal’s office, at 116 West Sycamore St. by 5:00 p.m. on _______________.
Issued By: ________________________________________________
Title: ____________________________________________________
(Ord. O-02-08, passed 6-5-2008)