Westbury Manor-CS 990415citizen complaint involving a
deficiency located within the city.
EMERGENCIES SHOULD BE REPORTED TO THE APPROPRIATE DEPARTMENT/DMSION IMMEDIATELY
Location of problem (be as specific as possible) Nearest Cron S~eet
Reported By: CompLMnt T~en By: DEPTJDI~. 'hone Nmber Date
CompL~m~nt: Address:
Fhoae Numbers: (~ome) (Work)
Forwarded to: ~.Bldg. Imp. ~ Env. Health ~ Fire __ Public Works ~ Po __ er
STREETS BUILDINGS PUBLIC WORKS OTH e:R
Excessive Litter
Sunken T~mch ~ Graflltk~N~ Paint __ Street Light Out __
Excessive Weeds
-- Broken Pavement __ Light out/Broken __ Street Light Knockover __
-- Broken Curb/ Fixture ~ Traffic Signal Out ~ Diegal Dump
-- Sidewalk __ Broken Window Traffic Signal Knockover ~ Inoperable Veldcle
Faded Street/Curb __ Sewage ComplaintY Z Floodlights out/Damaged (Not on Street)
-- Paint Water Leak __ Signal Lights __ Abandoned Vehicle
Present Sign Needs Blowing Trmh Other (Within Right-of-Way)
-- -- ~ Other
Repair/Replacement __ Dilapidated Fence, --
__ Storm Drain Needs Bldg/Structore
Cleaning __ No Permit
Abandonded Barricade/
Pylon w Other
Other
Physi. cal Inspection Shows ~. . · ..... :_~-- _~- -_- ,/ ~/ ~/.. V,d . ..,.----
,_
Dispos~do~
DEFICIENCY FORM REVISED 2/93