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SS VILLAGE OF SPRINGVILLE 5 WEST MAIN STREET SPRINGVILLE, NEW YORK 14141 (716) 592-4936 Notification/Complaint Form The Village Board has directed that all requests, issues of iriterest and/or complaints for the Code Enforcement and/or Village Board discussion be presented in i writing or by personal appearance before the Board. Village Board meetings are held on the first and third Mondays of each month. Items for discussion at the meeting miist be submitted to the Village Clerk no later than the Thursday preceding the scheduled meeting, to allow adequate time to research the request/complaint. Please use the space below to provide specific, detailed information of your request/complaint. Unsigned complaints will not be honored. DATE: Byaleu LOCATION grarpucansy) SS E Main St SUBECT. Mad ws loak in Ravtal12 wewrd Nous hah Blt San was voto ot Priow we ae iw Kall was shit Hie k FAH Cotta “Cheval Nash 2b wr panes Pre qed woth = sit + hak cst 4 macksy </b a7 me Go 2IPT= wae prt me rioKsg Stok of 27 = Regswact 2H CE OOOH. Signed: \WAndvsm Name: AM Ancds Mm Address: Soy — Mam Se 2p cling ville AN yyy | Telephone: “1 Ke S42. Ib 7