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i� <br />SNOHOMISH COUNTY BUILDING AND PLANNING DEPARTMENTS <br />C014PLAINT SHEET <br />The following must be completed in full: Date �^/,�'- 7 <br />. �A � <br />Name of Person causing alleged complaint d�Jl. -,:I,I�r.n(C' �F�d ������� fn • <br />Nature of alleged complaint`�o�� locuk m� o�' hrn��e r ��,.I.ar ��wF/� �i�.— <br />P.ddress or directions <br />Name of person reporting (please �ign) <br />Address ��h ��-���-_�dlil�v✓i, Qx��+ �n �n00 �Phone ��"�(�� <br />Under FC41 42.17.310, the Public Disclosure Law, you as complainant may in- <br />dicate a preference for disclosure or non-di�closure of your name to inquiries <br />from the public. <br />Please indicate by checking the appropriate box whether or not you wish to <br />disclose your identity reoarding public inquiries into this complaint. <br />�You may disclose my identity upon q You may not disclose rqy identity <br />public inquiries reqarding this upon public inquiries regarding <br />complaint. this complaint o-�ithout my per- <br />mission. <br />It should be undersCood that if the case is filed in court, that your name <br />must be disclosed if you are to be a witness in the case. • <br />'� G f' C% U'�i�� �- <br />U i I,A ) � i1 � W Q, CC I'" <br />DO NOT WRITE BELOW THIS LINE ' <br />***�*.*�******,r�++�**�.****�***�*�*��*�*�**�*****.***+��**�*�.******.�*�*.�*��:t��*** <br />Investinated by <br />Conditia�s found <br />Person(s) coiftactcd <br />Action taken <br />I.�I�IJl. �D�i. , ,i.(li <br />� <br />Results and follow-up rep��rt to be sent to 1 <br />� <br />� <br />✓��/ <br />�� <br />� <br />Date � �/—�� <br />(�,�' �G�k%I� ��i',t',�lu�!/ICP� �i,lCrZ.�v bh�i''�Ci ����v„l/%7i <br />�,�c����� Z �. �;r� .,��� �-G� `� ���.� a��c�eea� cu��? <br />�G��� j/s� .� � �� ,. <br />