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Compliance Investigation Form
Investigation# I/0 /O Date of Request: C:":"/'--->" i Time of Request:
Name of Person Making Request: C -
Address: Phone#
Investigation Type: r,,�
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Location (Address) of Violation: D1T (Id
Phone Number: Property Owner/Manager: Pal) /),n .1/vesfinen+3 1N C✓
Request Taken by: Investigator: 7Vg0 atcr /tea rkw<��
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Action Taken: L fr iv)al/ _(:;1 S//a/0 0-Fix Ft. 3 a a s-lo
Compliance: S/a cy/0
Legal Description: ag-03`./ 3S. -,- -- --LR 9C RE#: /7O 7-5-15--OO O O
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F:\Code Enforcement\Compliance Investigation Form.doc UCL 9 2009