CE 147 Levy Rd #62211backlog Compliance Investigation Form
Investigation# Date of Request: �7'Z ' Time of Request:
Name of Person Malting Request: Jt'n`- 6
Address: Phone# Z� -7C)34
Investigation Type: S At $ /
Location (Address) of violation: /4 -7
Phone Number: Property Owner/Manager:
Request Taken by: �f ���u/t Investigator:
Action Taken: '
Compliance:
Legal Description: _RE4:
FACode Enforcement\Compliance Investigation Form.doc
Oct 9 2009
` ACHES CUSTOMS AUTO REPAIR INC.
147 LEVY RD
ATLANTIC BEACH,32233 Date Invoice#
904-713-3010 7/8/2011 1116
Bill
I.C.O Full Thrrotle
Scott Bresnahan
904-315-0557
1125Ravenscraft Lane I
Ponte Vedra.Fl. 32081
UNIT#
Year Make/Model VIN Mileage Tag
2003 Concorde Limited 2C3HD56G93H572973 190153 JBI 35C
Quantity Description Rate Amount
Complete rebuilt motor 0.00
******CHANGE OIL IN 500 MILES*******
12 months 12,0000 warranty
Total $0.00
AN EXPRESS MECHANICS LIEN IS ACKNOWLEGED ON THE ABOVE VEHICLE TO Payments/Credits $0.00
SUCURE THE AMOUNT OF REPAIRS THERETO,UNTILL SUCH TIME AS CASH
PAYMENT HAS BEEN MADE IN FULL.IT IS UNDERSTOOD THAT YOU WILL NOT Balance Due $0.00
BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO CARS OR ARTICLES LEFT IN
CARS IN CASE OF FIRE,THEFT OR ANY OTHER REASON.UPON SIGNING THIS
Signature Date