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Investigation# S(g lQ 1:4 Date of Request: Z Time of Request:
Name of Person Making Request:
Address: PW Phone #
Investigation Type:
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Location (Address) of Violation: 6 T
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Phone Number: Property Owner: Ae> e/10
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Request Taken by: Investigator
Action Taken:
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Compliance: ' 904 - -414 — /0-7
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Legal Description: RE#:
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