15349 105th Ave SE 102402�F
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RECEIVED
0Ci 24 1002
CITY OF YELM OFFICIAL USE ONLY
PO BOX 479 Date Recalad
Yelm WA 98597 BY
(360) 458 -3244
CITIZEN ACTION REQUEST
NAME:
PHONE:
'360- Ya5 -7 3/6
25-3- V7 -7 '9 79
Home
Business
ADDRESS: /031 /oS* -A,1e
SE
Yel. 1,)4 gSf5-9
MAILING ADDRESS (B different than above):
.o. 4,v 33 -5
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DATE:
/0-2y-02-
TIME: 9'Do AM
SITUATION DESCRIPTION:
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CITY OF YELM POLICY NO, 91 -0 1
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For City of Yelm Official Use Only
Routed t On:
Response /Infonna on Given:
Suggested Action to be Taken:
Imo/ Wd U Oss I c t �!nCe
Complaint and suggested action to D�9pt.'fiead ILL21 �
Action assigned to:
Action to be initiated by
Action taken if other than above: �_(Lh•r�i �Q a+`� �o r%.
2 LC�l. i(.1.i1�iL tJC%S�.lnol�u . Cinl SMCC�O�
Satisfactorily resolved /Completed on:
By:
CITY OF YELM POLICY NO. 81 -01
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