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<br /> i'r���•_;���i�.:; ;:���, ......
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<br /> 2'roperiy Address `
<br /> ���__ -- 0:'ncr's Name i
<br /> Occunancy_ '- _
<br /> ----._.-----Otimer's Addres.^,
<br /> flo. Of Hou�inl; nit<: --------`"-
<br /> Secoud Pai�ty I
<br /> ���. of Stories ��`
<br /> Adtirc�;s
<br /> Construction Ty�e__� `-"�--- I
<br /> -- ._` Comnlaint? Yes p�o `�� �
<br /> llasenent; /�
<br /> I'ull. — �
<br /> -,____- By �:hom?
<br /> Date � /Q`' . "_----------__.,._.___ �
<br /> i—I�Tic;c z �
<br /> -/- __�__Insnector_�
<br /> D�te __ 'I'ivie �—
<br /> ----- --------�__P�rcel in .'.oned
<br /> Lot (s) _.__ Ulucl� �_
<br /> - �__Uimension o: Parcel
<br /> Plat -------_
<br /> '------___._._____Intrrinr C�tcrior
<br /> F+• Ihadequatc Sa:�itation; �
<br /> l 1. Lack of, or i,.proper watc c.lo;et, lavatorv L.rt 1
<br /> , htu ,, or sho;�rr,
<br /> i 2. I,ack of, or imoroper kitchen sink...
<br /> ' 3. ��k of I�ot and/or cold ruuninp, water to p] mbin, iixcw�e.
<br /> � 4. Lacl; of adequ,,te he�tinr; facilities. �
<br /> � � � ��
<br /> :"i',. t 5
<br /> , . Lack, or iiaPr�`Per eperation of require,l van i.lati�,r, ou�
<br /> i � ,, � 6. I.eck ef minimi m ae,ount.^, of uatural li�l,t r.n f ventilntion r�r•
<br /> !e,
<br /> � 7. Room and - ,• ]�7 codc.
<br /> spaa� dir.i.�:n;ions less thau r�equired by cnde,
<br /> U. lack of required electrical lirhtinq,
<br /> 4. uampnc:; oP hibitable room;. . .
<br /> l0. 7nfestait.ion n1 .
<br /> in,:�ct:; acrm.n
<br /> + , or roJrnYs.
<br /> � ].1. Gencra] delnp. darion or im�,rop�1� maint��n:ance. .
<br /> i li. I,ich o(' conne< tion to r�.•quir��d �.e��nr,c di�;�,o,al ;vnrer, ,
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<br /> �—��V�[J�-'-l�(� /�'`-Pil'� � . �, .,, .�� f n.�;1 t r;,,.:.
<br /> �'l // ` � _,�E'�''.�.c/G,��LC ... �l,�!
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