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AF - 34994J 1'" � � 0 e'� ,� COMPLAIIYT FORM � City of Fridley, Min� Alle�ed Violator Addse�a Addsees �MPLAINI' iVa �i �� t : ��e�,Lc,o, "d- o�,.,, /�'� . ! B�a. g Bau. � itp. Bua. o �• N Bua. �l r'�7� r� o e.x. . ��— O P 1s_ B�eferred To: � Bldg. Insp. Dept. Co�ats: i:.Qa�.a��Q� Heslth Dmp�ts'�t 2 � _ �. � Aafsrr u F�re nepartm�at �= O Police Depitstment C 8apost of Action Takan and Datas , ��9/�� -`��-� � ��-,�, � 9�-�. �ja, l l7� s i . �aa/�� - ��' `�'' n fanr .� �� s/t� tios. aan � oc�r. r : l� Fii�al Disposition C6ecked By: � i se� �� • w � �� . � � M � :, Q COMPLAINT FORM Cit�► of Fridley, Nlinn�ota Property Owaar see reverse st� for i ns tructt or�s Address �Adds�B �3 5�0 � Addsess VVQRK SHf ET e � �/_ 9� �; 8es . � �e. Res. , �s. � �es. E+ Bus. nt : ��Z�-'�.t.,Q.� �' 0"� i�C�—► , Co�plaint �sived �yr _ -- — Date (0 9 Referred To: � Bldg. Iaap. Dept. Ca�ts: , • � ❑ Health Depsxtmeat ❑ Fire Depastmes►t Beferrad By= Q Police Depa=t�t �u� e. • O Bsport of Action Taken and �te: �te; l�iaal Diepoaition CheckaS By: F011Y � IJ 6/�� !LO`. INBR pLlT. � A.�l. —OP_M_ > > - - sw �o � w w � � �� ► �� L � d 4 COMPLAINT PROCEDURE ACTION C �. � J 1. Complaint received, recosde+d on work aheet aad foraarded to Building Inapt�ctiaa Clerk �rpiat......••... Person Taking Complaint 2. Com4plaint e�tar�d os eos�Lsiut fos�, ouo�b�red� �� logg�d, �o ths c�plai� �ist, ammd giva� to thr �ilding 0fliaial ...............•••••..••••••••..••.••.• Clerk 1�ypist 3. Complaint referred to appropriate department or individual and returaed to C1erk Typiet for diaperement ............................................. Buildiag Official 4. Complaint forma diepersed ............................... Clerk ljipist a. iJork Sheet with camplaint number in addrese foldes b. 1 copy in maeter complaint file c. Other copies to dePBrtn�ts or individuals concerned. S. Record of action noted on master complaint for�......... Clerk Typist 6. Fiaal disposition checked ............................... Buildiag Official 7. Completed master complaint form filed in addrese file... Clerk Typist . _ .f-_ . .�- � , -, _ ..- _ . , . . _,. . , : - _ .� _ _ ,�- ,_ . ' :. � ��: - -. �,.: ; - ,_ .�.._ ._ _ . .�. �� . �� . . '�, : �•,. ` . - ��_ � .� _ � . .- � , . :,, : . , : i -_- - � �� _;',. � �'�'�� _ �;w.s, �a��e � �� .�= o ° -� �;�� a� �, �� ,. " . . _ � � � ' :: � _ � � � - . . - - -- �� . �-� � � � � � . � � � � �+�� :; -- -. ¢ � �� _ � _ 1 ��; _. _� �� .-- � - _ � . _. . - .� � � � �� . � _ _ �� " . ,��. , � ��- ` � _. . -, , _. ,�: �' � . . - �'` � ` � ,: ':,. : � � : � � _ _ ,'�� ,. �._ _ : ;S _ �. � _ _ - . .. .. .. �y . . �- .. .� ' . ` - � _ � i-. _ "_'. . . . . r . o y. _ t a _ . . . . . e . �rs _ .. .e - _ ... � _ _ _ �� . - . - r; ,�, _ < �� . . . _ � . . - _ _ . �. �.�. � _ ` ... {�.. _. . .. ., . ,- _ . • �. . - . . , - -� -., ._. . _ - ; . r=. . - ' -' �'.. , �,_' , -� �� . ..' : _ . ti . .(. � . �:� : . ' ; ' ,: � .. Y - � _ ' _ '. . , . s- .. _ .. . . v. . , � ..♦ � '� .� ' '-:. . �-- ... . '�, ... ;.� ..�.._: �.Y � al , _ ` ^i 1'.. . - . .. . '._-.. ,--. " '+. " _ _ _ , _ , .. . . . . _.. ..> ,. .. . . ., .. . `. . -�: - :. . "� .. - .. � .. ,. . �- � . .. '. ; . � "-.. � �'_ � - '. ., _..-. � - ' .. ,:- '. . .. -. _" . . �_ `� i '�` 'S .a'-. . � . ... - . . . , ... .... _, � . S- . _♦ � .. . .. . _ . . � - .:. . ',. . .>.. � v ... �- . -� � . .,. .� . . � :'" __ . . . . ..� � �... . . _ � _ -.: �. -a : - � . �� . .�. . ' � _., f { . �- .::dZ`. . . . ,. . . . ' . . _. .. . . . _ .. � o � 1�. 15685 � Building Job Report ADDRESS ,� C� ,��Q �,' �. � - �r _ OWNER ✓�+�. � � BUILDER DATE � PERMIT NO. DESCRIPTION � O.�l(� �� CX_P�-�t.t�J - - INSPECTION RECOR'D ' DATE ,�„ ,- � _ /� / REPORT h o� l�/ s 7 6 l.� �C./ .� i4--`� �, � � u 2 .tL ��rJ � % -� OWNER - REP. � INSPECTOR . ; .� � � 6 � ,� F�: �� ` �� , , �, ,��,..r �- 1 � �� . � � � �� I v , , ; f, � . � ��' t '.i� ��.�:.��, . �:�.-��.. � � o t� c.� �- N , � !�l'l� - `7'j c—.e.-,-,.,.. �S�-/.r .5.-- � 1�� 1596�.� Building Job Report ADDRESS � �,�jj �� 7�� OWNER BUILDER DATE /� _a� -�� PERMIT NO. DESCRIPTION lH,�n o r I . I,.,., // _�R ,v n < IWSPECTION RECOA'D �-� DATE REPORT � �� _._�/l �4 i� � ,_,/ � � NNER - REP. INSPECTOR