HomeMy WebLinkAboutBuilding without Permits - BLD Letters / Memos - 8/6/2003 INQUIRY BY NAME
Name Cd GILB3720 GILBERT, STEVE B 6980 NE TAHLYA-BLACKSMITH
BELFAIR, WA 985288778
1 RP 22304 77 90091 TR 9-A OF SURV 13/40 20, 000 T
TR C OF SP #1934 9110
- INVESTIGATION REPORT FORM b
Revised 01 22/03 (/LJC/ 15 n n
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Part A: Nature of Complaint
• Initiator's Name:
• Address:
• Telephone:
• Owner Name:
• Address:
• Telephone:
• Department of Concern
❑ Clerical ❑ Building ❑ Health ❑ Comm Development ❑ Fire Q�
• Area of Concern: C)
❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other 1
Refer to Director
• Location of Concern:
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• Site Address
• Nature of Concern:
• DOES COMPLAINTANT WANT TO REMAIN ANONYMOUS ❑ Yes ❑ No
Part B: Concern Intake and Referral
Received By: Referred To: Response Date:
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Name Date Name Date Date 0
Part C: Findings V'�` � y
Referral Forwarded to: ❑N/A
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Name Date
Findings:
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Part D• Resolution
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Date '
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