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Ordinance Violation

Antwerp Township
24821 Front Avenue
Mattawan, MI 49071
269.668.2615

Date: ____________________
Name: ______________________________________________
Address: ____________________________________________ City:_____________________
Home Phone: (______)______________________ Work Phone: (______)__________________
Property Number: 80 -________-__________-__________-________
Tax Plate Number:_______________________
Owner/Occupant (if different than above):____________________________________________
______________________________________________________________________________

Description of Violation:_________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Antwerp Township Zoning Ordinance Section & Paragraph No. __________________________


(See attached ordinance)
Other Information: ______________________________________________________________

This violation must be corrected within ________days


from date of receipt.
_______________________________________
Enforcement Officer

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