HomeMy WebLinkAboutComplaint Form 2008-5-30 y�BRCv LOG IN DATE:
COMPLETION DATE:
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY ]0573
(914) 939-0668
COMPLAINT FORM
DATE: FOR OFFICE USE ONLY
LOCATION: PO at - en(1 e
NEW S.B.L.: `► ( • � I OLD S.B.L.: I — 4� a USE:
OWNER: 6ane-
Address&Phonee:�ieA p ` y�,�
SOURCE: ► c t-�o r Phone/Letter/Other:
Address&Phone:
COMPLAINT: QVQaS GVECCVCxA`ln - m Ke- a
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POSSIBLE VIOLATION:
INSPECTORS LOG
DATE STATUS INSPECTOR
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