HomeMy WebLinkAboutBuilding without Permit - BLD Letters / Memos - 4/11/1995 INVESTIGATION REPORT FORM a
Revised 10/6/94 / lT1
Part A: Nature of Complaint
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• Initiator's Name:
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• Address:
• Telephone:
• Owner Name:
• Address:
• Telephone:
• Department of Concern
❑ Clerical ❑ Building ❑ Health ❑ Comm Development ❑ Fire
• Area of Concern:
❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other
Refer to Director
• Location of Concern:
• Nature of Concern:
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Part B: Concern Intake and Referral
Received By: Referred To: Response Date:
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Name Date Name Date Date
Part C: Findings
Referral Forwarded to: ❑N/A
Name Date
Findings: 0a 4,J40r k bw...,„a
Part D: Resqltjltion
N me / Date
Intake Copy-WWte File Copy-Yellow Referral Copy-Pink