Fillable RENTAL HOUSING COMPLAINT FORM F Building & Zoning (City of Groton, CT)

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RENTAL HOUSING COMPLAINT FORM F Building & Zoning (City of Groton, CT)

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RENTAL HOUSING
COMPLAINT FORM
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Building & Zoning Department
295 Meridian Street Groton, CT 06340
Telephone 860-446-4104
Date of Complaint: _______________ Complaint #: ______________
Nature of Complaint: Rental Housing Building Violation
Blight Zoning Other; description ________________
Property location: _____________________________________________________
Owner of Record/Property Manager: _________________________________________
Owner of Record/Property Manager Address: __________________________________
Owner/Property Manager Telephone #: ______________ Email address: ________________
Details: _______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(If more space is needed please attach an additional sheet)
Name of Complainant: _______________________________________________________
Address of Complainant: _____________________________________________________
Complainant’s Telephone #: _________________ Email address: ___________________________
Complainant’s signature: _______________________________
For Office Use Only:
Verification Inspection Date: _________
Violation(s):
____________________________________________________________________________________
Comments:
Follow up with Complainant:
Inspected by: _____________________
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RENTAL HOUSING COMPLAINT FORM F Building & Zoning (City of Groton, CT)

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Completed 31 January 2021

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