HomeMy WebLinkAboutDog House Built without Permit - BLD Letters / Memos - 9/30/2022 1 .
} r INVESTIGATION REPORT FORM
., 7,V p Revised 10/6/94
Part A: Nature of Complaint
• Initiator's Name:
• Address:
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• Telephone:
• Owner Name: u%
• Address:
-4i Telephone:
• Department,of Concern
❑ Clerical Building ❑ Health ❑ Comm Development ❑ Fire
• Area of Concern: ° -
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"°"y ❑ Process Delay ❑ Personnel ❑ Policy/Fee Code Violation ❑ Other
Refer to Director
A Location of Concern: 1 it `) for y� fry�1�
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l • Nature of Concern:
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Part B: Concern Intake and Referral
Received By: Referred To: /
/ Response Date: fl?
Name Date Name Date Date '' 00
Part C:Findings
Referral Forwarded to: /iry ��%�^ `�' 2 ❑N/A
Name Date
r' Findings: //1/k' _ CL`yC SG.a JN C��Ce/ e?� �7G,�p..v��i t /G/
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Part D: Resolutio�nf f'
N me / C Uf Date
Intake Copy-White File Copy-Yellow Referral Copy-Pink '
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