Printable Complaint Form

TOWN OF WILLINGTON
LAND USE DEPARTMENT
40 Old Farms Road
Willington, CT  06279

(860) 487-3123      
(860) 487-3117 Fax


COMPLAINT FORM

(Information MUST BE COMPLETE and can be obtained in the Assessors Office)

DATE  _________________

ADDRESS OF PROPERTY  ____________________________________________

ASSESSORS MAP _________________ AND LOT NUMBER  ________________

NAME OF LEGAL OWNER     __________________________________________

NATURE OF COMPLAINT     ___________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

NAME OF COMPLAINANT     __________________________________________

ADDRESS OF COMPLAINANT  ________________________________________

E-MAIL  _____________________________        Telephone No.  _____________     

                                                                        

SIGNATURE OF COMPLAINANT ______________________________________


(Office Use)

REFERRED TO: _____________________________________________________

DISPOSITION: ______________________________________________________

Common/Complaint Form