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II�SF',.-.CS1o1! ii::I'i;;;i <br />2'r; ,,,�y r'.�: �; ._�O ZL�� � mer's 17ame (.�� 4/�-c�.t- �4.� ��.c/2_ <br />U^cupancy C% � 3�^�er�s Addres, <br />i!o. Of Y.ousing Unit; r� Second Party ��0�,�� <br />l:o. of Storie� 2 Address <br />Co��r,truction i'yne �( � I� CoTplaint? Yes ,'�o <br />_�..-1 <br />1�c :c:.�ent: 1�u11_Z�p Uy ahom%_ <br />llc�t:, �i� Z ` �Tim��-------^-- Insnecto; <br />Dat.e Tim, Parcel in .'.oned <br />Loc (s) Dlec'.. Uimension of Parcel <br />Pl•�t <br />it, Inadequate Sazitation: <br />Interior F.xterior <br />1. Leck of, or i.�,:proper wate:,clo�et, lav�to:v, batht�ib, or shrnaer. <br />2. Lsd< of, or innroper }:itcl±en :ink.,. <br />... I�ack of hot aid/or cold runnin� water to pL.:�abing fixtu7+�. <br />��. [�ack of adeq�ixte i�eatin;; facilii:ies. <br />:,. 6ack, or impi•nper operatiou of requirnd�vanrilatinr equipnent� ' <br />G. l.sck of mini.mam amotmC� of natuxal lir,ht an] ventilation reg. hy cede. <br />7. Room and space dimensious l.ess than requirel by code. <br />�. Iack of required electrical liqhtin,.^,. <br />si. :,anpness of- habitable roorrs. ` <br />]o. Infestation of insect�, vennin, cr rodents. <br />�_ }�1� <br />11. General delapi.daiion or improper maintenanc�.ly <br />12. 1.3ch oC connecYion to required sewaF,e dispn:al Svstem, <br />.. . I.:.r1, n� .�An.�u:�l'o n:lt'L.�1;. an.l ��u1.1�;0.� r.��,.�,,.� :nvt r.-.r..�:.�1. (;inilitin . <br />�p �1'�'l1-e/_�1 _. <br />i ` � u <br />