HomeMy WebLinkAbout952330.tiffRESOLUTION
RE: AUTHORIZATION FOR THE WELD COUNTY ATTORNEY TO PROCEED WITH LEGAL
ACTION AGAINST SHERRIE SELLMER FOR VIOLATION OF THE WELD COUNTY
ZONING ORDINANCE
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado
statute and the Weld County Home Rule Charter, is vested with the authority of administering the
affairs of Weld County, Colorado, and
WHEREAS, Sherrie Sellmer, VI #2231, is allegedly in violation of the Weld County Zoning
Ordinance, and
WHEREAS, despite efforts by the Planning staff to resolve said matter, the violation has
not been corrected, and
WHEREAS, on the 14th day of November, 1995, a public hearing was held before the
Board of County Commissioners for the purpose of hearing testimony relating to said violation, and
WHEREAS, Sherrie Sellmer, property owner, was present at said hearing, and
WHEREAS, the Board of County Commissioners deems it advisable to delay referral of said
violation to the Weld County Attorney's Office until March 12, 1996, to allow adequate time for the
property owner to apply for and have approved a Use by Special Review Permit and for an
inspection of the property by the Department of Planning Services staff, and
WHEREAS, the Board deems it advisable to proceed with legal action against the above
named individual without further Board action if the subject property is not brought into compliance
by March 12, 1996.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that if said violation still exists on March 12, 1996, the Weld County Attorney be,
and hereby is, authorized to proceed with legal action against Sherrie Sellmer to remedy the
violation of the Weld County Zoning Ordinance, and any other persons occupying the properties,
any persons claiming an interest in the properties, and any persons acting in active concert with
the identified parties.
952330
PL0824
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APP
VI #2231 - SELLMER
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 14th day of November, A.D., 1995.
rwI. _..... e
Weld= party Clerk to the Board
k .V1iuge_
the Board
AS TO FORM
W. H. Webster
Dale K. Hall, Chair an
BOARD OF COUNTY COMMISSIONERS
LD COUNTY, CQLORADO
•
1
XL/ rA
Barbar? J. Kirkmeyer, P-Tem
jL
• GeeorgiE. Baxter /
( � 2-L/.5x.A✓' . ftriee.fi1A`'
Constance L. Harbert
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1wa--
952330
PL0824
COLORADO
Inspection Report
NAME: Sherrie Sellmer
LEGAL DESCRIPTION OF PROPERTY:
Pt of the N2 of Section 32, Township 6 North,
Range 66 West, Beg 975.5W N4 cor S484'
W180' N484' E180' To Beg, Weld County,
Colorado
DATE OF INSPECTION: November 13, 1995
CASE NUMBER: VI -2231
The property was inspected to determine compliance with section 31.2, 31.3 and 31.4 of the
Weld County Zoning Ordinance. The property is not in compliance at this time. There is an RV,
Boat storage business located on the property. I did talk to the property owner. She said that
she would have the a Use by Special Review application submitted by November 13, 1995.
(Before the Board of County Commissioners Hearing). In order bring the property into
compliance the business needs to be removed or the Use by Special Review permit obtained.
Susan McMullen
Zoning Inspector
pc: VI -2231
952330
DATE: November 8, 1995
VIOLATION NUMBER: VI -2231
NAME: Sherrie Sellmer
ADDRESS: 13276 Weld County Road 64
Greeley, Co. 80631
LEGAL DESCRIPTION: Pt of the N2 of Section 32, Township 6N, Range 66 West of the 6th
P.M., Weld County, Colorado
CASE SUMMARY:
June 20, 1995
July 19, 1995
July 25, 1995
July 25, 1995
August 8, 1995
August 11, 1995
August 14, 1995
August 15, 1995
September 25, 1995
September 25, 1995
October 24,1995
October 25, 1995
Complaint made and assigned to Julie Chester.
Property inspected. Property is in violation.
Five -Day compliance encouragement letter sent.
Telephone conversation between Chris Goranson and Sherrie Sellmer
discussing possibility of Use by Special Review.
Telephone conversation between Julie Chester and Sherrie Sellmer.
We will hold off on sending the violation until August 23, 1995 on
condition that progress made on Use by Special Review.
Letter from Sherrie Sellmer indicating her intentions to persue a Use by
Special Review Permit.
Telephone conversation between Susan McMullen and Sherrie Sellmer
indicating that the letter of intent had been received and that we would be
holding off on the violation.
Letter From Chris Goranson to Sherrie Sellmer advising her to apply for a
Use by Special Review and enclosing an application packet.
Property inspected. Property is in violation.
Zoning Violation notice sent.
Property inspected. Property is in violation.
Letter sent to property owner indicating that the violation case was
scheduled before the Board of County Commissioners. Enclosed was a
copy of the violation Notice.
October 31, 1995 Telephone conversation between Chris Goranson and Sherrie Sellmer
discussing the possibility of having to put up screening on her property.
952330
The R.V., Boat Storage Business is a violation of Section(s) 31.2, 31.3, and 31.4 of the Weld
County Zoning Ordinance. To correct the violation a Use by Special Review permit needs to be
applied for and obtained from the Department of Planning Services, or the business needs to
be removed.
The Department of Planning Services also recommends that the County Attorney be authorized
to proceed with legal action against any other persons occupying the properties, any person
claiming an interest in the properties, and any persons acting in active concert with the
identified parties.
952330
❑ SKETCH PLAN
❑ PRELIMINARY PLAN
❑ FINAL PLAT
❑ RESUBDIVISION
❑ FHDP
❑ GHDP
❑ USR
LI AMENDED USR
❑ USR MINING
❑ USR MAJOR FACILITY
❑ USR DISPOSAL SITE
❑ Shani Eastin ❑ Gloria Dunn
❑ Susan McMullen ❑ Ed Stoner
❑ ❑
❑ MINOR SUB SKETCH PLAN
LI MINOR SUB FINAL PLAT
❑ ZONING
❑ ADDRESSING
LI BUILDING PERMIT
LI SETBACKS/OFFSETS
❑ HOME OCCUPATION
LI VIOLATION
❑ OTHER
❑
11•'/.
WELD COUNTY DEPARTMENT OF PLANNING SERVICES/BUILDING INSPECTION
CITIZEN INQUIRY FORM
1400 N. 17TH AVENUE, GREELEY, CO 80631
PHONE: (970) 353-6100 EXT. 3540 FAX: (970) 352-6312
ejl TELEPHONE ❑ OFFICE FIRST INQUIRY? U YES 0 NO DATE: I C -
NAME: PHONE:
ADDRESS:
TYPE OF INQUIRY:
❑ MHZP
❑ ZPMH
LI RE
LI AMENDED RE
❑ SE
O -AMENDED SE
LI SITE PLAN REVIEW
❑ REZONING
❑ PUD SKETCH PLAN
❑ PUD DISTRICT
❑ PUD FINAL PLAT,
PERSONNEL
LI Keith Schuett
❑ Chris Goranson
❑ Ken Schlueter
ITEMS DISCUSSED:
,CAT;u1A.
3&- !
1/4
❑ Todd Hodges
❑ Roger Vigil
--
4-7 To
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Th
Time Spent
citizen
Staff Member's Initials
452330
(Ac*,
WIWDC.
COLORADO
October 25, 1995
Sherrie L. Sellmer
13276 Weld County Road 64
Greeley, CO. 80631
DEPARTMENT OF PLANNING SERVICES
PHONE (303) 353-6100, EXT.3540
FAX (303) 352-6312
WELD COUNTY ADMINISTRATIVE OFFICES
1400 N. 17TH AVENUE
GREELEY, COLORADO 80631
Subject : VI- 2231
Legal Description: Pt of the N2 of Section 32, Township 6 North, Range 66W, Beg 975.5W N4
cor S484' W180' N484' E180' To Beg, Weld County, Colorado
Dear Sherrie L. Sellmer,
The property referenced above remains in violation of the Weld County Zoning Ordinance. I
have scheduled a meeting with the Board of County Commissioners on November 14, 1995 at
10:00 a.m. to consider the Zoning Violation occurring on your property. This meeting will take
place in the County Commissioners' Hearing Room, first floor, Weld County Centennial Center,
915 Tenth Street, Greeley, Colorado. It is recommended that you or a representative be in
attendance to answer any questions the Board of County Commissioners might have about the
violation.
The Department of Planning Services' staff will be recommending that the Board of County
Commissioners authorize the County Attorney to proceed with legal action to remedy the
violation. Our records indicate that you were made aware of the nature of the violation, the
action necessary to correct the violation, and that you were given sufficient time to remedy the
violation. The property will be reinspected November 13, 1995.
If you have any questions concerning this matter, please call me.
Sincerely,
./^/i-m ,
/74/146
Susan cMullen
Zoning Inspector
pc: VI -2231
952330
WUDe
ft6t.w.;
COLORADO
NAME: Sherrie L. Sellmer
Inspection Report
LEGAL DESCRIPTION OF PROPERTY: Pt of the N2 of Section 32, Township 6 North,
Range 66W, Beg 975.5'W N4 cor S484' W180'
N484' E180' To Beg, Weld County, Colorado
DATE OF INSPECTION: October 24, 1995
CASE NUMBER: VI -2231
The property was inspected to determine compliance with section 31.2, 31.3 31.4 of the Weld
County Zoning Ordinance. The property is not in compliance at this time. There is still an R.V.
boat storage business on the property without a Use by Special Review Permit. The business has
to be removed or the proper zoning permit must be obtained. The owner did say that she has
started the Use by Special Review process but that she still needs to make a map of her property.
She did say that she would have her application turned into the Department of Planning Services
by November 10, 1995.
/j1i
Susan McMullen
Zoning Inspector
pc: VI -2231
95233O
COLORADO
DEPARTMENT OF PLANNING SERVICES
PHONE (303) 353-6100, EXT.3540
FAX (303) 352-6312
WELD COUNTY ADMINISTRATIVE OFFICES
1400 N. 17TH AVENUE
GREELEY, COLORADO 80631
WELD COUNTY
ZONING VIOLATION NOTICE
September 25, 1995 Violation Number : VI -2231
Sherrie L. Sellmer
13276 Weld County Road 64
Greeley , Colorado 80631
Legal Description : Pt of the N2 of Section 32, Township 6 North, Range 66 West, Beg 975.5'W N4 cor
S484' W180' N484' E180' To Beg, Weld County, Colorado
The uses on the above described property are being considered as a zoning violation of Section 31.2,
31.3 and 31.4, of the Weld County Zoning Ordinance. A RV, Boat storage business is not a use allowed
by right in the Agricultural Zone district. The violation can be corrected by removing the business or by
applying for a "Use by Special Review" . If the "Use by Special Review" is the option of choice an
application packet can beobtainedfrom the Department of Planning Services.
It is the intentionofthis office to assist and cooperate with you without imposing undue hardships;
however, we have no discretion in this matter if you fail to correct this violation. You have 30 (Thirty)
days from September 25, 1995 to correct this zoning violation. Failure to do so will result in this office
scheduling the violation before the Board of County Commissioners to consider whether to refer the
violation to the County Attorney's office for legal action.
Any information you have that may help to resolve this matter will be helpful. This office is ready to be
of any assistance in clarifying or answering questions concerning this matter. Please call or write the
Department of Planning Services' office.
Sincerely J /iry
ii lh C -C
Susan McMullen
Zoning Inspector
pc: VI- 2231
952330
Actetr
!Pc
NAME: Sherrie L. Sellmer
Inspection Report
LEGAL DESCRIPTION OF PROPERTY:
Pt of the N2 of Section 32, Township 6N, Range
66W, Beg 975.5'W, N4 cor S484'
W180'N484'E180' to Beg , Weld County,
Colorado
DATE OF INSPECTION: September 25, 1995
CASE NUMBER: VI -2231
The property was inspected to determine compliance with section 31.2, 31.3 and 31.4 of the
Weld County Zoning Ordinance. The property is not in compliance at this time. There is still a
RV, Boat Storage business, located on the property. The property owners have not completed or
submitted a "Use by Special Review" packet that was sent to them by Current Planner Chris
Goranson. It does appear that there are more recreational vehicles parked on the property then
during previous inspections.
usan McMullen
Zoning Inspector
pc: VI -2231
952330
'liRe.
COLORADO
August 15, 1995
Dale and Sherrie Sellmer
13276 WCR 64
Greeley, CO 80631
Subject: Use by Special Review Permit
Dear Mr. and Mrs. Sellmer:
DEPARTMENT OF PLANNING SERVICES
PHONE (303) 353-6100, EXT.3540
FAX (303) 351-0978
WELD COUNTY ADMINISTRATIVE OFFICES
1400 N. 17TH AVENUE
GREELEY, COLORADO 80631
Thank you for your letter received on August 11, 1995. Staff reviewed your letter and came to the
conclusion that applying for a Use by Special Review permit would be the best direction for you to
follow. I have included a USR packet that gives additional information pertaining to the purpose of the
USR and includes the application as well. If you have any further questions, please feel free to call me at
the number above.
Sincerely,
ris Goranson
Current Planner
952330
WELD COUNTY DEPARTMENT OF PLANNING SERVICES/BUILDING INSPECTION
CITIZEN INQUIRY FORM
1400 N. 17TH AVENUE, GREELEY, CO 80631
PHONE: (970) 353-6100 EXT. 3540 FAX: (970) 352-6312
It4TELEPHONE ❑ OFFICE FIRST INQUIRY? ❑ YES ❑ NO DATE: D eir /`/ qS
NAME: f.,
ADDRESS:
PLA, - cc/l ine r
PHONE: 35,2 — W6 ASS
TYPE OF INQUIRY:
O MHZP
❑ ZPMH
❑ RE
❑ AMENDED RE
O SE
O AMENDED SE
O SITE PLAN REVIEW
O REZONING
❑ PUD SKETCH PLAN
O PUD DISTRICT
O PUD FINAL PLAT
PERSONNEL
❑ Keith Schuett
❑ Chris Goranson
❑ Ken Schlueter
ITEMS DISCUSSED:
hp./c!
V9-(
-kc.t w e
Cora ns o.-. Q n O& W u ..LACY
❑ SKETCH PLAN
❑ PRELIMINARY PLAN
❑ FINAL PLAT
❑ RESUBDIVISION
❑ FHDP
❑ GHDP
❑ USR
❑ AMENDED USR
❑ USR MINING
❑ USR MAJOR FACILITY
❑ USR DISPOSAL SITE
❑ MINOR SUB SKETCH PLAN
❑ MINOR SUB FINAL PLAT
O ZONING
❑ ADDRESSING
❑ BUILDING PERMIT
O SETBACKS/OFFSETS
O HOME OCCUPATION
O VIOLATION
❑ OTHER
❑ Shani Eastin O Gloria Dunn O Todd Hodges
❑ Susan McMullen ❑ Ed Stoner O Roger Vigil
O ❑ O
1/ -roe,/ w e w O ..1d
Cr% 1/1(,rc✓,ge/ vie 1a7le-n 4.c Lc
w e et< s t n4wenA0 *tC t. 1.1-0
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Time Spent
citizen
Staff Member's Initials
952330
Dale and Sherrie Sellmer
13276 Weld Co. Rd. 64
Greeley, CO 80631
August 8, 1995
writ) COUNTY PLANNING
D. AUG 1 1 1995 n
Weld County Department of Planning Services
1400 North 17th Avenue
Greeley, CO 80631
Attention Mr. Chris Goranson
Dear Mr. Goranson:
I apologize at the delay in getting this letter out to you. My grandmother fell and
fractured her hip and our lives have been turned upside-down ever since. Please tell Julie
Chester as well. This letter is a follow-up to the phone conversation we had a couple of
weeks ago regarding our request for a USR permit on our property located at the above
address.
My husband and I would like to respectfully request a special use permit to store boats
and RV's on the southeast -quarter of our property. We did not realize that we were in
violation of a zoning ordinance when be put our sign out front to help our financial
situation a bit! Only the -southeast -quarter of our property will be used for the storage --
however many will fit and still allow easy access for all occupants. We will not allow this
to become "junky" as we have pride in our home and do not want it to become an eyesore.
We hope the board will vote favorably and grant us a permit --we will cooperate in any
way possible. Thank you for your consideration. Please run this letter by Julie so that she
is aware of our intentions.
Yours truly,
9r0 f 9a - L2t Sa
Dale Sellmer Sherrie Sellmer
952330
WELD COUNTY DEPARTMENT OF PLANNING SERVICES/BUILDING INSPECTION
CITIZEN INQUIRY FORM
1400 N. 17TH AVENUE, GREELEY, CO 80631
PHONE: (970) 353-6100 EXT. 3540 FAX: (970) 352-6312
a'TELEPHONE O OFFICE FIRST INQUIRY? CI YES 4:KO
NAME: SLIAAAA /
ADDRESS: / -� 2 19 (4) C I . lo1
TYPE OF INQUIRY: ////
O MHZP
❑ ZPMH
❑ RE
p AMENDED RE
❑ SE
U AMENDED SE
❑ SITE PLAN REVIEW
❑ REZONING
O PUD SKETCH PLAN
❑ PUD DISTRICT
❑ PUD FINAL PLAT
PERSONNEL
❑ Keith Schuett
❑ Chris Goranson
❑ Ken Schlueter
❑ SKETCH PLAN
❑ PRELIMINARY PLAN
❑ FINAL PLAT
❑ RESUBDIVISION
❑ FHDP
p GHDP
❑ USR
❑ AMENDED USR
p USR MINING
p USR MAJOR FACILITY
❑ USR DISPOSAL SITE
❑ Shani Eastin
❑ Su�n,McJylu)ler)„
DATE
7
PHONE: 35--z 8? -6
❑ MINOR SUB SKETCH PLAN
❑ MINOR SUB FINAL PLAT
❑ ZONING
❑ ADDRESSING
❑ BUILDING PERMIT
❑ SETBACKS/OFFSETS
❑ HOME OCCUPATION
9LATION
❑ OTHE2
B' 4S
❑
Ry (tit 44.7(
O Gloria Dunn ❑ Todd Hodges
❑ Ed Stoner ❑ Roger Vigil
❑ ❑
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Staff Member's Initials
952330
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CITIZEN INQUIRY FORM
,Telephone 0 Office
/(� First Inquiry? Yes ❑ No
(/ \�� Name: ii�!;�: i Date: —177-
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Address: %C) I -, ,/Ji la 2 1 -, -; ._- 2s:7 7
COLORADO
Type of Inquiry: //WE;_
Personnel: -
❑ Keith Schuett ❑ Shani Eastin 0 Gloria Dunn ❑ Todd Hodges
Chris Goranson 0 Sharon White Dother:
ITEMS DISCUSSED: • ; ,
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Telephone 0 Office
First Inquiry? 0 Yes 0 No
Name:
Address:
Say.
Date: /-
Type of Inquiry:
Personnel:
❑ Keith Schuett 0 Shani Eastin 0 Gloria Dunn 0 Todd Hodges
Chris Goranson ❑ Sharon White ❑other:
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952330
pcf1:1
Wine
COLORADO
July 25, 1995
Sherrie L. Sellmer
13276 Weld County Road 64
Greeley, CO, 80631
DEPARTMENT OF PLANNING SERVICES
PHONE (303) 353-6100, EXT.3540
FAX (303) 352-6312
WELD COUNTY ADMINISTRATIVE OFFICES
1400 N. 17TH AVENUE
GREELEY, COLORADO 80631
Subject: C-95-86, Legal Description: Pt of the N2 of Section 32, Township 6N, Range 66W,
Beg 975.5'W N4 cor S484' W180' N484' E180' to Beg, Weld County, Colorado
Dear Ms. Sellmer:
It has come to the attention of the Department of Planning Services' staff that the uses on your
property (13276 Weld County Road 64) may not be in compliance with the Weld County Zoning
Ordinance. The potential noncompliance with the zoning ordinance is an RV, Boat and trailer
storage located on the property.
Please call me within five working days of the date of this letter to review the concerns with me.
Sincerely,
Id le
Julie Chester
Zoning Inspector
pc: C-95-86
SLR VICE. TEAMWORK. INIEGRIJY, QUALITY
952330
iett
WUDc
COLORADO
NAME: Sherrie L. Sellmer
Inspection Report
LEGAL DESCRIPTION OF PROPERTY:
DATE OF INSPECTION: July 19, 1995
CASE NUMBER: C-95-86
Pt of the N2 of Section 32, Township 6N, Range
66W, Beg 975.5'W N4 cor S484' W180' N484'
E180' to beg, Weld County, Colorado
The property was inspected to determine compliance with section 31.2, 31.3, and 31.4 of the
Weld County Zoning Ordinance. The property is not in compliance at this time.
There is a RV and Boat Storage Business located on the property. There is a sign advertising the
business, located on the north side of the property, adjacent to WCR 64. 1 spoke with the
property owner at the time of the inspection and she was not aware that this is not a use allowed
by right in the Agricultural Zone. At this time she has two trailers stored on the property. To
bring the property into compliance the business would need to be removed from the property or
a USR permit would need to be applied for and approved by the Department of Planning Staff. I
told Ms. Sellmer that she would need to come into the office or call a planner to discuss the USR
process.
One photograph was taken at the time of inspection.
citzbei 1)/
Julie Chester
Zoning Inspector
952330
PARC TP: R
PIN: 1362586 PARC:
SELLMER SHERRIE L
PARCEL INQUIRY
,0532000044
ASSM' YR: 1995
...AST UPDATE:
ACTIVE ON:
INACTIVE ON:
MAP#:
ATIIN02�
04/10/1995
09/16/1986
/ /
2169
13276 WELD CO RD 64
GREELEY CO 80631
TAX AREA 0400 .076196 1994
DATE LAST ASSESS 04/21/1995
LAST ASSESS LAND 3150
LAST ASSESS BLDGS 7950
TOTAL LAST ASSESS 11100
PRIOR YEAR ASSESS 8190
REC DT 03/24/1994 DEED TP QCD
NUMBER 1433 02380077 WOL N
DOC FEE 0.00
17973-E PT N2 32 6 66 BEG 975.5'W N4 COR S484'
W180' N484' E180' TO BEG %13276 WCR 64
PF3: PROFILE
PF4: OWNERS
MESSAGE:
1112
TOT LAND
1212
4279
TOT BLDGS
TOTAL VALUE
PF5:LEGALS PF7:NEXT PARCEL
PF6:DOC HIST PF10:PLOC
3110
3110
6460
1400
7860
10970
PF11:MENU
PF12:REAL
952330
WELD
PROPERTY
C- NTY ASSESSOR/TREASURER
1 2ATOR BY PROPERTY ADDRESS
AT=3809_
R 080529000039
ALLISON ALBERT L JR & BE 13165
1358386
R 080529000039 1358386
ALLISON ALBERT L JR & BE 13165
R 080529000039 1358386
ALLISON ALBERT L JR & BE 13165
R 080529000039 1358386
ALLISON ALBERT L JR & BE 13165
R 080532000044
SELLMER SHERRIE L
R 080532000044
SELLMER SHERRIE L
ACTIV 09/16/1986
64
ACTIV 09/16/1986
64
ACTIV
64
ACTIV
64
1362586 ACTIV
13276 64
1362586 ACTIV
13276 64
09/16/1986
09/16/1986
09/16/1986
09/16/1986
INACTIV
CR
INACTIV
CR
INACTIV
CR
INACTIV
CR
INACTIV
CR
INACTIV
CR
/
WELD
/
WELD
WELD
WELD
/
WELD
/
WELD
/
/
/
/
PF1:SELECT PF7:BACK PFB:CONT PF9: RESTART PF10:PARC PF11:REAL PF12:MENU
MESSAGE:
952330
DEPARTMENT OF PLANNING SERVICES
COMPLAINT REPORT
r ONING COMPLAINT Complaint Initiated by:
❑ BUILDING CODE COMPLAINT gaff o Citizen ❑ Other
LEGAL DESCRIPTION:
VIOLATION ADDRESS: V 3 W LQ- i4 Co Sint-)
Parcel # ATTACH COPY OF DEED
Property Owner's Name: _
Property Owners Address:
Tenant's Name and Mailing Address:
Phone #
352-8
NATURE OF COMP L INT: c -
n
'I
J. C c-cf C 4.n)
_4
Zoning Complaint Referred To: c
Date. i "7 L S
Building Code Complaint Referred To: Date:
Case Assigned To: Date:
ACTION OF INVESTIGATOR:
Date of Inspection:
Inspection of property indicates:
o No violation of the Weld County o Zoning / ❑ Building Code Ordinance
Referred to: on
o No violation of the Weld County ❑ Zoning / ❑ Building Code Ordinance
o Violations of the following Sections of the o Zoning
o Building Code Ordinance
ACTION ON COMPLAINT:
o No Action Taken/No Violation ❑ Violation File Started
Date Date
CASE REVIEWED BY SUPERVISOR Date
SUPERVISOR'S COMMENTS
NOTE: Attach all pertinent information and facts disclosed by investigation to this form.
o? QYs
nota
952330
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