LambtonShoresCommunityAssociations

RecordofConcernsForm
By-law: 519-238-5246

O.P.P.: 519-238-2345

Please pass on copies of these filled-in sheets to the Lambton Shores Community Association,
for compilation of documentation at the end of this 2014 summer season. Our website is
www.lsca.lsca.blogspot.com or email us at lscommunityassoc@gmail.com.

Date of the concern:______________________________________________

Your name:_____________________________________________________
Your Lambton Shores Address:_____________________________________
Phone Number: _________________________________________________
Check one: I am owner of this property: ____
I am renting this property: ____
Address of your concern: ___________________________________________
Lambton Shores Subdivision (Plan 24, Huron Woods, etc.): _________________
Nature and description of your concern (noise, nuisance, parking, etc.):

Log of your calls and the response you received (time and who you called):

LambtonShoresCommunityAssociations
RecordofConcernsForm
By-law: 519-238-5246

O.P.P.: 519-238-2345