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276 3rd St (vault) CITY OF ATLANTIC BEACH COMPLAINT MANAGEMENT SYSTEM TAKEN (date/time) ft"- ;'� -�'� ` 1 /No: COMPLAINANT: Last Name First Name M ADDRESS: -:? JE,-1,v. CITY/STATE/ZIP: TELEPHONE: ( . ) -��' '�� COKPLAINT �- - idiomT7 LOCATION: REAL ESTATE #: PROPERTY OWNERS NAME: OWNERS ADDRESS: PROPERTY OWNERS PHONE: ( ) - OCCUPANT: DEPARTMENT FORWARDED TO: COMPLAINT TAKEN BY: Z -- DATE/TIME: OFFICE USE ONLY INVESTIGATED: (date/time) 8,-,tom - S' ASSIGNED DEPT./DIVISION: PRIORITY: INVESTIGATOR: CONDITIONS FOUND: ACTION TAKEN: lY 3.Q,ar„�5= f3A•�-. TXv Gil �.� G Gr/o l�y�' COMPLIANCE: NOTES: t CITY OF ATLANTIC BEACH , ^� SPECIAL INVESTIGATION "til 7o TO BE FILLED OUT BY COMPLAINTANT DATE ADDRESS LOCATION COMPLAINT 0 OWNER OF PROPERTY S=EE OF COMPLAINTANT LSC/ f PHONE O o2 Y�7-54 5KcG5::-, ----------------------------------- FOR OFFICE USE ONLY - DATE OF INVESTIGATION INVESTIGATOR yO CONDITIONS FOUND - v;l k r-fir ACTION TAKEN COMPLIANCE NOTES: