HomeMy WebLinkAboutHouse Built without Permit in Woods - BLD Letters / Memos INVESTIGATION REPORT FORM n a
Revised 6/3/93
Part A: Nature of Complaint
• Initiator's Name: '� Q
• Address:
• Telephone: - C
• Owner Name: / Cl t `
• Address:
• Telephone: - 1
• Department of Concern
❑ Clerical Buildingiealth Comm Development ❑ Fire O
• Area of Concern:
❑ Process Delay ❑ Personnel ❑ Policy/Fee ►Code Violation ❑ Other
Refer to Director
• Location of Concern:
C)
• Nature of Concern: 14ous>31 Ru l t.I-S. t,J j n Re R.t Cr I lV
Part B: Concern Intake and Referral
Received By: Referred To: Response Date:
Name Date Name Date Date
Part C: Findings
Referral Forwarded to: ❑N/A
Name Date
Findings:
Part D: Resolution
Name Date
Intake/File Copy-White Referral Copy-Yellow Referral Copy-Pink Tracking Copy-Gold