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Compliance Investigation Form
Investigation#o26 // Date of Request: / t9// Time of Request: 7,i.:2(J /)04
Name of Person Making Request: T4f 4/,,/ p,
Address: 7----- 1,j t L._0(5-ta,Y /�1—ta,t3 Phone#
Investigation Type:
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Location (Address) of Violation: /93/ /9 Cle.,e ,
Phone Number: 09419—65 '7 Prope , Owner anager: 9E1/{ie,,(> 2
Request Taken by: Investigator: 41:64
Action Taken: /4(:)/9 /./(7i) (5r- -)Ii J i-c,
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Compliance: /13/// v y/
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