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Get Mountlake Terrace City Complaint Form

ACTIVITY VERIFICATION/ COMPLAINT FORM 6100 219th Street SW Suite 200 Mountlake Terrace WA 98043 Phone 425. 744. 6267 Fax 425. 775. 0420 PermitSpecialist ci. mlt. wa.us www. cityofmlt. com Note Processing The completion and filing of this form initiates an investigation of the reported condition. A detailed written description of condition s being reported including how long the condition has existed is needed. Date of Inquiry Address of Property to be Investigated DESCRIPTION OF ACTIVITY VERIFICATION / COMPLAINT Please be specific give details Inquiry Received By Activity Verification Processing Date FOR CITY OFFICE STAFF S USE ONLY Name of Occupant / Property Owner Address City State Zip Email Address Name of Requestor Is follow up requested Yes No REFERRED TO Date initial and return to Permit Specialist Engineering Planning Building Fire Police Other RESULT OF INVESTIGATION AND ACTION TAKEN NOTE Please enter your investigative results under the processing number. Ordinance/chapter/section of the code violated By N CDForms 2009 Permit Applications ComplaintForm5. ACTIVITY VERIFICATION/ COMPLAINT FORM 6100 219th Street SW Suite 200 Mountlake Terrace WA 98043 Phone 425. 744. 6267 Fax 425. 775. 0420 PermitSpecialist ci. mlt. wa*us www. cityofmlt. com Note Processing The completion and filing of this form initiates an investigation of the reported condition* A detailed written description of condition s being reported including how long the condition has existed is needed* Date of Inquiry Address of Property to be Investigated DESCRIPTION OF ACTIVITY VERIFICATION / COMPLAINT Please be specific give details Inquiry Received By Activity Verification Processing Date FOR CITY OFFICE STAFF S USE ONLY Name of Occupant / Property Owner Address City State Zip Email Address Name of Requestor Is follow up requested Yes No REFERRED TO Date initial and return to Permit Specialist Engineering Planning Building Fire Police Other RESULT OF INVESTIGATION AND ACTION TAKEN NOTE Please enter your investigative results under the processing number. Ordinance/chapter/section of the code violated By N CDForms 2009 Permit Applications ComplaintForm5. 744. 6267 Fax 425. 775. 0420 PermitSpecialist ci. mlt. wa*us www. cityofmlt. com Note Processing The completion and filing of this form initiates an investigation of the reported condition* A detailed written description of condition s being reported including how long the condition has existed is needed* Date of Inquiry Address of Property to be Investigated DESCRIPTION OF ACTIVITY VERIFICATION / COMPLAINT Please be specific give details Inquiry Received By Activity Verification Processing Date FOR CITY OFFICE STAFF S USE ONLY Name of Occupant / Property Owner Address City State Zip Email Address Name of Requestor Is follow up requested Yes No REFERRED TO Date initial and return to Permit Specialist Engineering Planning Building Fire Police Other RESULT OF INVESTIGATION AND ACTION TAKEN NOTE Please enter your investigative results under the processing number. Ordinance/chapter/section of the code violated By N CDForms 2009 Permit Applications ComplaintForm5.

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  • 219th
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