HomeMy WebLinkAboutComplaint 60123 TOWN OF YARMOUTH
1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451
�+ Telephone(508)398-2231 Ext.1292 Fax(508)398-0836
II 0143D O NG'S HIGHWAY HISTORIC DISTRICT COMMITTEE
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,� ��o,_ac-,vESP , COMPLAINT FORM �� 2! er 34
Date: MAy' 25- 2.02-3PLEASE PRINT CLEARLY
Property Address of Complaint: / 3 y ke 4 A/> U
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Property Owner Name(s)
Property Owner Mailing Address:
Description of Complaint: Go K a E AJ G A-Al b ALL. I
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The following information is required for prompt investigation. Failure to provide your name,
address and contact information will result in the OKH Committee and/or the Building
Department to process this complaint at their discretion.
Please note that this information is kept confidential unless you are required to testif as a witness
in a court of law.
Complainant Name: h: / a, /i 430 0.. S
A/ 1 1/Lela 112 a G r-/ o AJ
Address:
Phone: J 3 2 (6--- 0�6- r�(kt iIP ZC rrCP- v DE7° 5—ro
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Preferred Method o Contact(check one) Phone: Email:
I Prefer to Remain Anonymous [ ] (check box)
OFFICE USE
Method of Submission: In-person Email Mail Referred to Building Date: