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Compliance Investigation Form
Investigation# Q L,S 1 O Date of Request: I 1 I J3
_6)__Tim,Time of Request: 3'.67
Name of Person Making Request: AL fJ.ILL
Address: Phone#
Investigation Type:
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Location(Address)of Violation: 111ZI er�xp �J..S..n�
Phone Number: Prope Owner nager:
Request Taken by: Investigator: Z=!R��4 w
Action Taken:
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Compliance: z I A , f�
Legal Description: RE#:
FACode Enfb c mt\Complimm Imeti¢azion Form.doc Oct 9 2009