16345 Birkland St Mantoris CAY ° PNV
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AUG 15 2000
CITY OF YELM
PO BOX 479 oa o R•�ol�a
Yelm WA 98597
(360) a
(360) 458 -3244
COMPLAINT RECEIVED FORM
COMPLAINANT
PHONE:
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Home Business
MAILING ADDRESS (if different than above):
COMPLAINT: (use back or additional paper If needed) C2!2��- Z5
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For City of Ye/m Official Use Only:
Response/Informadon Given:
Suggested Action to be Taken:
Complaint and suggested action to Dept. Head
Action assigned to:
Action to be initiated by / /
Action taken if other than above:
Satisfactorily resolved /Completed on:
By:
CITY OF YELM POUCY NO. 91 -01
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