Complaint 299 Atlantic 2012 � 'Ly. r
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Compliance Investigation Form
Investigation# Date of Request: 7 / /Z. Time of Request: =J�
Name of Person Making Request:
Address: Phone#
Investigation Type:
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Location (Address) of Violation: d4,rle.� / T jf
Phone Number: Property Owner/Manager:
Request Taken by: Investigator: /T1 '?-lrr- Z
Action'Taken: �/001�pol q4 (110 be 1C,0 A-S 5-e-4 v r 2
Compliance:
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Legal Description: RE#:
FACode EnforcementTompliance Investigation Form.doc Oct 9 2009