NO PERMIT NUMBER 6115 5hadygrove
INVESTIGATION RECORD J ' e
Location 6119 ^c"X^ �. File No. `f �' O
OWNER'S Name
Address Phone
Other Responsible Party
Address — — 44 N%Type of Investigation^ Q^ SAN. �
Remarks `
Date Received " ` " V Date Closed r "10
Form 28045 3M 11/64 J
F,11 5 ChaAvm m.a