HomeMy WebLinkAboutUnlivable Structure Being Lived In - BLD Letters / Memos - 7/2/1996 INVESTIGATION REPORT FORAIt1�`���
Revised 10/6/% r)
Part A: Nature of Complaint
• Initiator's Name: �.
• Address:
• Telephone:
• Owner Name:
Add
• S} l lac�C�F! -
i Address: � a"Z
• Telephone: a' 'd
• Department of Concern X
❑ Clerical Building ❑ Health ❑ Comm Development ❑ Fire
• Area of Concern:
❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other
Refer to Director
• Location of Concern:
C Mt, a(,
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• Nature of Concern:
Part B: Concern Intake and Referral
le' : Referred To: Response Date:
ZMJL :
Date Name Date Date
Findings
Referral Forwarded to: ❑N/A
Name Date
Findings:
Part D: Resolution
Name Date
Intake Copy-White File Copy-Yellow Referral Copy-Pink