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COMPLAINT GIVEN TO BUILDING INSP. � f- j ,:
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BUTTE COUNTY DEVELOPMENT SERVICES
COMPLAINT FORM
Date: _"T- (-7--()Q AP# 1 1i - /,aO -(3
Owner: %�eU11/1 Alda Zoning: AR
Address: Z� q:5 S C P_a n o+k j, -s Abkr— General Plan:
Complaint/Violation
TYPE: [4uilding n
COMPLAINT: A
Permit History on File: [J,,jKone [ ]As follows:
Complaint Taken B}
Caution: [ ]Yes [ ]No
Approx. Size of Bldg.[M.H.
[ ]Occupied Has Electricity: [ ]Yes [ ]No
[ ]Vacant Has Sanitation: ( ]Yes [ ]No
Under Construction: [ ]Yes [ ]No
Hazards:[ ]No [ ]Yes,(explain)
Person Contacted:
Approx. Age of Bldg./M.H.
Has Gas: [ ]None [ ]Propane [ ]Natural
Obvious Sewage Problems? [ ]Yes [ ]No
Built by/for: [ ]Present Owner [ ]Previous Owner
Describe Action Taken:
INSPECTOR MUST ATTACH A COPY OF THE CORRECTION NOTICE!
ACTION RECOMMENDED
Inspector: Date:
[ ]Information Only, File [ ]Hold for Days
[ ]Complaint Unfounded [ ]Other
[ ]Resolved per Inspector's Report [ ]Send Letter for Compliance
BUTTE COUNTY DEVELOPMENT SERVICES
Complainan
Address
Phone Number:
Other Comments:
Inspector must draw a plot plan with all building locations:
Additional Comments from Inspector:
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