HomeMy WebLinkAboutBuilding Going On After Dark - BLD Letters / Memos - 5/8/1997 INVESTIGATION REPORT FORM a
Revised 10/6/94
Part A: Nature of Complaint
• Initiator's Name: o`
• Address: �``�
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• Telephone:
• Owner Name: Rpm! /5
• Address:
• Telephone:
• Department of Concern
❑ Clerical `�.J' Buildin ❑ Health ❑ Comm Development ❑ Fire
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• Area of Concern: � •,
❑ Process Delay ❑ Personnel ❑ Policy/Fee []d-Code Violation ❑ Other
Refer to Director
• Location of Concern: flz
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• 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
ame Date
Findings ' lL
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Part, Resolution
ame / Date
Intake Copy-White File Copy-Yellow Referral Copy-Pink
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