Zoning complaint form

PROPERTY MAINTENANCE, MS4 AND

ZONING COMPLAINT FORM

Please print clearly, if we cannot read the form, we will not be able to pursue the complaint.

EAST PETERSBURG BOROUGH

6040 MAIN STREET

EAST PETERSBURG PA 17520

PH [phone]

FAX [phone]

Date Filed _______________________

Property Address: _________________________________________
Owners Name (If Known): ___________________________
Nature of Complaint (print clearly), please list any additional violations at this property:

Information will be kept confidential or disclosed only in accordance with state or federal laws.
Your Name: _________________________________
Address: ___________________
Telephone No.: ________________________________________________
Signature: _______________________________________________________

(Signature Required)

ACTION TAKEN: