HomeMy WebLinkAboutWorking in the Buff, Marked with Stakes, Cutting All Vegetation on the Shoreline - GRD Letters / Memos - 10/14/2014 ' Case Number:
Mason County Investigation Report Form
Parcel Number. -32-I Z - f _- 60 133 ' 13<t)
Violation Site Addr s: npT'
Property Owner(s): 7�! Phone :
Mailing Address: �}�2L � t'Yl i i 1�vt _ I ►�
Tenant/Contractor/Operator on site:
Directions to Site: L r, ,L^_LLIVn L1,,d cI 6; X L-1a)C IL :`3L E
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Under the provisions of the Public Disclosure Law 42.56.240, the complainant may indicate a desire
for disclosure or non-disclosure of their identity. If non-disclosure is chosen, this portion of this form will
not be released to the public unless this case is�iled in court. If filed,your name will be disclosed if you are
a witness in the case.
Mason County investigates possible violations on a complaint basis only. Therefore,the name of the person filing
the complaint should be provided. —Z— '
Please check one of the following:
❑ Please do not disclose my identity. I understand that disclosure may be required by court order or if this
matter goes to court (r -
❑ You may disclose my identity. �•./ C
Name(please print): Phone:
Address: � Q�
Strut City Stye Zip `
Signature of Complainant: Date:
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THIS SECnON FOR MASON COUNTY USE ONLY
Complaint Received by: Date: U ' `� -2.0►`-�
Complaint Received by. ❑Em ❑ Web Site An Person
Department of Concern:tm g Plannin ElFire ElPublic Works
Environmen eat Solid ❑ On-site ❑ Wells ❑Food ❑ Other
Investigation Daze and Findings: / Y.c�j/76 JT 0 �./
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