HomeMy WebLinkAboutEvaluate Proposal to Run Double Pipe Waterline from Meter Across Wetland to Proposed SFR - BLD Letters / Memos - 10/4/2002 INVESTIGATION REPORT FORM
Revised 10/6/94
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Part A: Nature of Complaint
• Initiator's Name:
-- • Address:
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• Telephone:
• Owner Name: L. w
• Address: f I % f t r'-\
• Telephone:
• Department of Concern _
p ❑ Clerical ❑ Building ❑ Health Comm Development ❑ Fire
• Area of Concern:
❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other
Refer to Director
• Location of Concern:
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• Nature of Concern: C
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art B: Concern Intake and Referral
Received By: I Referred To: Response Date:
Name 61'•`Date L Name Date Date
Part C: Findings
Referral Forwarded to: ❑N/A
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Findings: J 1 r S t� ! �,.. V - G ��J .✓ t^X T
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Part D: Resolution
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Name Date
Intake Copy-White File Copy-Yellow Referral Copy-Pink
TAX PARCEL NUMBER: Zz
OWNER: Sk- i42
VIOLATION: k, low
STATUS:
DATE:
SITE VISIT NOTES:
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