CE 399 Beach Avenue 2011 Rte: 110 ►T 1-poo p
�` 111,,- Compliance Investigation Form
Investigation# A.36"/ Date of Request: %\ t t Time of Request: 1 ',1 J
Name of Person Making Request: -b �tj
Address: Phone#
Investigation Type: 6
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Location(Address) of Violation: .-- g 0—Ue-.
Phone Number: PropertyCwner anager: 1[1 . C
Request Taken by: Investigator:
Action Taken: p.±.):ACS)
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Compliance: s\,Qt 1C LA._A -Qt L 1'\
Legal Description: RE#:
F:\Code Enforcement\Compliance Investiaation Form.doc Oct 9 2009