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. _�.�,�..r.�d r,l.,� . 3v_z� .� � _ _-- _ - - - - <br /> , •- SNOHOMISH COUNTY COPIt1UHITY DEVELOPt1L•�T C-4510-1 <br /> - • . Rev 12/87 <br /> Af R 15 1998 <br /> . <br /> COMPLAINT INVESTIGATION REQUEST CASE N0. <br /> COMMUI�ITY OEVELOPMENT <br /> � I : UATE: _ <br /> �; Tax Account No. (if known): 3028b5—�— �����9 <br /> � � Name:�[�R• �C �15,Q�l1 Phone No. r _ <br /> � � Address: � S r o l � � 5-z S � City: �s'✓—1 Zip: c' `?J <br /> � � Violation Location: /�/,(� C/'ftJ Gl�llZ�j �i��El1 'P <br /> •� 1 —�Z2_—c»p.� <br /> �'?�"""ts l� Q..�j <br /> DETAILS OF COMPLAINT: �/!l�^ �i7�° nILIS �1 Q�i�S' fiaS DUityX'SEi' 4�� 89. <br /> The r�rrf'� �i•fi. �oe doz�rs �n h��, C��.r .� c� <br /> �17r: �� h� �fi� � � � % � <br /> �fl,� hnrn�i� aF � w c� <br /> � f � / a <br /> � /�/l"/4i� ,in Q�P 4�4 � G�min� Su.p �O / P, S�r� <br /> .aa /rc ,�s <br /> XXXXXXXXXXx xXxxXXxXxXxXxXxXXxXx xXXxXXXXXxXXxx Xxx XXXxXX XXxxxXXXX XxxXXX xxx XC�� <br /> COMPLAINANT: 3�8 05����/a�y� HOME q: �7—yC�'/ <br /> Name: ���� l ��-:�'iE //��'�P:f/ WORK q: y0,3"y�OZ - <br /> Address:�27— /�-U � •-7�.�- �E City: �2'cri /�.�?ip:� <br /> ****Under RCW 42.17. 130, The Public Disclosure Law, you as complainant may indicate a <br /> preference for disclosure or non-disclosure of your name to inquiries from the public. <br /> Please indicate by checking the appropriate box whether or not your wish to disclose <br /> your identity regarding public inquiries into this complaint. <br /> �� Yuu may disclose my identity upon � You may not disclose my identity <br /> public inquiries re9ardin9 tliis � upon public inquiries regarding <br /> complaint. this cnmplaint without my <br /> permiss�on. <br /> •***It should be :inderstood tiwt if the case is filed in court, that Your name must be <br /> disc osed if ou are [o be a witn s in the case. <br /> Signature of Complainant: � .rC�J Dat • � � i <br /> G��. , L' //✓ ��/�� �� <br /> �:� <br /> ✓ 4; <br /> � <br />