Complaint Form by 9c01PDQ

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									                                                      Greenbrier County
                                  Dilapidated Building and Neglected Property Review Board
                                                                            OFFICIAL COMPLAINT FORM
Pursuant to §7-1-3ff and §7-1-3kk of the West Virginia Code and the Greenbrier County Dilapidated Building and Neglected Property Ordinance, the Property Review Board
shall receive complaints from the general public concerning: dwellings, other buildings, or any combination thereof that may be unfit for human habitation due to dilapidation or
defects increasing the hazard of fire, accidents, or other calamities; lack of ventilation, light, sanitary facilities, or any other conditions prevailing in these dwellings or other
buildings whether used for human habitation or not, which would cause such dwellings or other buildings to be unsafe, unsanitary, dangerous, or detrimental to the public
health, safety, or welfare, whether the result of natural or manmade force or effect; and receive complaints from the general public concerning accumulation of refuse, debris,
overgrown vegetation, toxic spillage, or toxic seepage located on private lands which may be deemed to be unsafe, unsanitary, dangerous, or detrimental to the public health,
safety, or welfare, whether the result of natural or manmade force or effect.



                                                                            Complainant Information
                                                            Required. Complaint will not be processed without this information.

Complainant's Name:                                                                                             Telephone Number:
                                First                                Last                                                                  Area Code

Mailing Address:
                                Street, Rural Route, or Box Number                         Town or City                           State                          Zip Code




                                        Dilapidated Building or Neglected Property and Owner Information
                                                            Required. Complaint will not be processed without this information.

Owner's Name:                                                                                                   Telephone Number:
                                First                                Last                                                                  Area Code

Mailing Address:
                                Street, Rural Route, or Box Number                         Town or City                           State                          Zip Code

Property Address:
                                Street, Rural Route, or Box Number                         Town or City                           State                          Zip Code

Physical Location:                                                                                              Tax District:
                                Street or Road Name and Community or Neighborhood Commonly Known As

Directions to Site:

Tax Map:                                            Parcel:                                               Deed Book:                              Page:




                      Nature of Complaint and Description of Dilapidated Building or Neglected Property
                Please describe in detail the nature of your complaint. The criteria for identifying a dilapidated building or neglected property is outlined above.




Please print legibly or type. Use the back of this form if additional space is necessary. Please feel free to submit any other information that may be relevant to your complaint.


                 Please return completed form and any other information that supports your complaint to:
                       Greenbrier Count Dilapidated Building and Neglected Property Review Board
                                 200 North Court Street, Lewisburg, West Virginia 24901



Complainant                                                                                Date Complaint Signed                           Date Complaint Received by PRB




Property Review Board President                                                            Date Complaint Reviewed by PRB                  Case Number

								
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