Laserfiche WebLink
<br />{p <br /> <br />City of <br />Centerville <br /> <br />o <br /> <br />City of <br />Circle Pines <br /> <br />O City of <br />Lexington <br /> <br />O Circle-Lex <br />Police <br /> <br />NO.: <br /> <br />PART I: BACKGROUND <br /> <br />COMMMUNlTY AC1ION NOTICE <br />Taken By: ~CUl..Q.U lA.k..i:bJt~ate: q-R-q<.}- Time: IZ:IS"" am,€) <br /> <br />Phone #'s: H: <br /> <br />Complainant <br />l~~)r d 01 YKO'iQ)r <br />~ lb@., ~)r(} i1CS-W tLlJ . <br />1053-\3Z/6 W: (o44-507b <br /> <br />Date: q -lq -Q <.f <br /> <br />Name: ~ <br />Address: ) <br /> <br />.. <br /> <br />Complaint Infonnation <br /> <br />Address: <br /> <br />Name (if known): <br /> <br />Phone: <br /> <br />o Junk <br /> <br />o <br /> <br />D Animals <br /> <br />o Noise <br /> <br />other <br /> <br /> <br />What type of Response is Required: ~Immediate <br /> <br />Does Complainant Require a Response: ~. Yes By: <br />No <br /> <br />Complaint Referred to: i ~~Q()l~ <br /> <br />PART IT: FOLLOW UP <br /> <br />o As Time Permits <br /> <br /><K.. Phone ~ail <br /> <br />Dept: <br /> <br />Action Taken: <br /> <br />Signature Date <br /> <br />Department <br /> <br />Was Complainant Informed of Action Taken: Yes <br /> <br />No <br /> <br />Person Contacting Complainant: <br /> <br />Signature <br />I PART III: ADDITIONAL INFORMATION/COMMENTS <br /> <br />Date <br />