HomeMy WebLinkAboutCoplaint Form 2011-2-8 LOG IN DATE:
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4 :.7r•C, �� ''O� COMPLETION DATE:
1902
BUILDING DEPARTMENT ASSIGNED To:
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573
(914) 939-0668 ASSIGNED BY:
COMPLAINT FORM
RECEIVED BY: r _
DATE: 2I FOR OFFICE USE ONLY
LOCATION: D �YC C'�t C �Ac _
NEW S.B.L.: `c�� OLD S.B.L.: I - S J ZC Eq—USE: 9e-S
OWNER: rif lu o yukl f Ir ". Oct" V101 u p dc4- cl 0 Vl
Address&Phone: p
SOURCE: ry) V hwa 4 Z Phone/Letter/Other: T tlo✓Z
Address&Phone: 7
COMPLAINT: I71'I 5LAC l C�YI �� cy� 1
POSSIBLE VIOLATION:
INSPECTORS LOG
DATE STATUS INSPECTOR
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