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1 , <br /> r . - ' ' OFFICE OF COMMUNITY DEVELOPMENT �'-'" >V`-`"� <br /> , . <br /> ' COMPLAINT SHEET <br /> TAX ACCOUNT NO. �=;.'•_�. ���'/�'�� ��-3��` ��'� ) FILE NO. � <br /> The� following MU9T be completed in full: <br /> Name of Person causing alleged complaint � . L7� . <br /> •�— <br /> Nature o! ell�ged cothpiaititi �,P�� „/n�� o—r,�it. ,p,���.�.T.', <br /> . � , L_ i <br /> � h.t.[.,�.. �Ll-, 7 7�_ .Pi�.3.:t <br /> � - <br /> Address or �irections _'Sj � � C�.r�J"�,a� CU/-Pi. <br /> � �� . (i��Z"a.1�y'� �4�� LAu(ZF.c.. I1�.i�twTS <br /> i <br /> Name of �erson reporting (please sign) <br /> Address �U � � �{-S��' /�7/ �l'7 ,u�',c�r�, �% �t'� 7S <br /> Phona No. 353 -6 � 9a <br /> *****Under RCW 42.17.130, The Public Disclosure Law, �ou as complainant <br /> may indicate a preference for disclosure or non-disclosure of your name <br /> to inquiries from the public. <br /> Please indir_ate by checking the appropriate box whether or not you wish <br /> to dis lose �your identity regarding public inquiries into this complaint. <br /> L�/ You � disclose my identity /� You m� not disclose my <br /> upon public inquiries identity upon public inquiries <br /> regarding this complaint. regarding thie complaint with- <br /> out my permission. <br /> ***It should be understood that if the case is filed in court, that your <br /> name must be disclose if you are to be a witness in the'case. <br /> DO NOT WRITE BELOW THIS LINE (Office Use Only) <br /> ******,r*****r**,r*,r,e**+*,r,t****,r,t*r***,r*,t,t*,trr****,e*****r,t*****«************** <br /> Investigated by DATE <br /> Conditions found <br /> Person(s) contacted ___ <br /> Action taY:en <br /> � <br /> Results and follow-up report to be sent to <br /> —__-- --- I <br /> L 'J <br /> ` _ <br />