NO PERMIT NUMBER 7'r-k��mROGI2ANDE PI,AGE k y.
I�JVEST�TION RE�C7ORD'
Location 1r-77�v4�& 6 W12&WGEL Y4—, Complaint
Occupant I/.W. LURA Rec'd
Add ress Phone
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Complaint StatementGA�
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Complainant Phone
Address
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REV. 1/78 FORM 280-898