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N0'.'-0'?-1953 12^34 <br />'iinaonk. <br />CITi’ OF HltUlETOrrH bll 33 =• !;I44 P.03 03 <br />ITT??/' <br />Received By: <br />Referred To: <br />Status:____ <br />Date: <br />Date Ref: <br />Reinspect: <br />Complainant: <br />Address;___ <br />Compiainant Must Bt Notified of Actions Taken. Date Notified: <br />Ph. #: (d). <br />Ph. #; (e)_ <br />INFORMATION ABOUT PERSON COMPLAINING CANNOT BE RELEASED BY LAW 1 <br />Location:_______ <br />Owner of Property: <br />Owner Address:_ <br />Tenant Name:___ <br />Complaint: <br />Complaint Information <br />PID# <br />Owner Phone: <br />Tenant Phone: <br />• • <br />Dates Findings And Actions Taken Initials <br />(Ccntmuvd cn Back of Paj«) <br />total f.o: