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<br />~ <br /> <br />City of <br />Centerville <br /> <br />o <br /> <br />City of <br />Circle Pines <br /> <br />D City of <br />Lexington <br /> <br />D Circle-Lex <br />Police <br /> <br />NO.: <br /> <br />CO:MMMUNITY ACTION NOTICE <br /> <br />Taken By: <br /> <br />Date: <br /> <br />Time: <br /> <br />am/pm <br /> <br />PART I BACKGROUND <br /> <br />= : <br /> Complainant <br />Name: _1)}' OJ'\.L WC/-t-cnrJ- Date: <br />Address: <br />Phone #'s: H: W: <br /> Complaint Infonnation <br />Address: <br />Name (if known) : Phone: <br />0 Junk Vehicle 0 Weeds 0 Animals D Noise 0 Other <br />;EE~~m<#J!itn~~jOftAe~'h~~rK <br />What type of Response is Required: 0 Immediate D As Time Permits <br />Does Complainant Require a Response: Yes By: Phone Mail <br /> - - - <br /> No <br /> - <br />Complaint Referred to: Dept: <br />= PART n: FOLLOW UP <br />Action Taken: f)c-kfk1uJ)~feJ ~~ /) Jrt)'/l J- -+- ~h,lY'ed '10 C~~ ~LT <br /> 7 <br /> Signature Date Department <br />Was Complainant Informed of Action Taken: Yes No <br />Person Contacting Complainant: <br /> Signature Date <br />r PART III: ADDITIONAL INFORMATION/COMMENTS <br />