HomeMy WebLinkAboutConstructing and New Fence - BLD Inspections - 10/20/2000 INVESTIGATION REPORT FORM ! `�
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Revised 10/6/94 `
Part A: Nature of Complaint
1 • Initiator's Name:
• Address:
• Telephone:
• Owner Name:
• Address: >� 1 Gl. Z
• Telephone: -
• Department of Concern
❑ Clerical �3 Building ❑ Health Comm Development ❑ Fire
• Area of Concern:
❑ Process Delay ❑ Personnel ❑ Policy/Fee Code Violation ❑ Other
L Refer to Director
• Location of Concern: /
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• Nature of Concern: I C-)1
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Part B: Concern Intake and Referral
1
Receiv d By: Referred To: Response Date:
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:... Name wrn Date Name Date Date
Part C: Findings
Referral Forwarded to: ❑N/A
Name Date
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Part D' Resolution 7�'S 177NY 13e p S401,x Gi-Vc s 15-S&C, mr- YN•��/ P��Tt•►«5.
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Name ;, Date
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