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<br />NOTICE OF ADMINISTRATIVE HEARING RIGHTS <br /> <br />You may petition for an administrative bearing pursuant to sections 120,569 and 120.57, Florida Statutes, If you <br />disagree with the facts stated in the foregoing Notice of Intcmded Department Action (hereinafter Notice), you may <br />petition for a forma~ admini~trative hearing pursuant to section 120.57(1), Florida Statutes. If. you agree with the <br />facts stated in 'the Notice, you may 'petition for an informal administrative hearing pursuant to section 120.57(2), <br />Florida S1l\tut~s. You must file the petition with: <br /> <br />Clerk of Agency Proceedings <br />Department of Transportation <br />Haydon Bwns Building <br />. '605 Suw~ee Street, MS 58 <br />Tallahassee, Florida 32399-0458 <br /> <br />The petition for an administrative hearing must conform to the requirements of section 120,54(5)(b)4, Florida <br />Statutes, and either Rule 28-106,201(2) or Rule 28-106.301(2), Florida Administrative Code, and must be filed with <br />the Clerk of Agency Proceedings by 5:00 p,m,. no later than 10 days after you received tbe Notice, The petition for' <br />an administrative hearing should include a copy of the Notice, and must be legible, on 8Y2 by II inch white paper, <br />and contain: ' <br /> <br />1. Your name, address, telephone number, any Department of Transportation identifying number on the <br />Notice, if known, the name and identification number of each agency affected, if known, and name, <br />address, and telephone number of your representative, if any; which shall be the address for service <br />purposes during the course of the proceeding; <br /> <br />2. An explanation of how your substantial interests will be affected by the action described in the Notice; <br /> <br />3. A statement of when and how you r~ceived the Notice; <br /> <br />4. A statement of all disputed issues of material fact. If there are none, you must so indicate; <br /> <br />5. A concise state~ent of the ultimate facts alleged, including the specific facts the petitioner contends <br />warrant reversal or modification of the agency's proposed action; as well as an explanation of how the <br />alleged facts relate to the specific rules and statutes the petitioner contends require reversal or <br />modification of the agency's proposed action; <br /> <br />6. A statement of the relief sought, stating precisely the desired action the petitioner wishes the agency <br />should take in respect to the agency's proposed action, <br /> <br />!fthere are disputed issues of material fact a formal hearing will be held', where you 'may present evidence and <br />argument on all issues involved and conduct cross-examination, If there are no disputed issues of material fact an <br />informal hearing will be held, where you may present evidence or a written statement for consideration by the <br />Department . <br /> <br />Mediation, pursuant to section 120.573, Florida Statutes, may be available if agreed to by all parties, and on such <br />terms as may be agreed upon by all parties, The right to an administrative hearing is not affected when mediation <br />does not result in a settlement. <br /> <br />A petition for an administrative hearing shall be dismissed, if it is not in subs'tantial compliance with the <br />requirements of either Rule 28-106,201(2) or Rule 28-106,301(2), Florida Adrninistrative Code, or ~f $.e petition <br />has not been timely fIled. If your petition is dismissed you will have waived your right to have the intended action <br />reviewed pursuant to chapter 120, Florida Statutes, and the action set forth in the Notice shall be conclusive and <br />fmal. <br />