HomeMy WebLinkAbout1416 golden state violation 3-29-13_2019032116351626e1 innnAeDV n1= V1(11 ®TWINS .
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certify that the violations noted above on this Notice to Comply /Summary of Violations have been
corrected. I have, personally examined any documentation attached to the certification to establish that
the, violations have been corrected.
Signature:
Title:
Print Name:
Date.,
KPS #8446
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VIOLATION
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REQUIREMENT FOR CORRECTION OF
VIOLATION
DATE FOR
CORRECTION
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Received by m
Print. Name:
Inspectors
Signature: 4fvf x) .. > ;.
Phone:`
Date:
Date:. F -
.
..�...- .��r��w -- ns1 /'1r r!!iCT1IMKI Tit CuMADI L& Mr-l=
certify that the violations noted above on this Notice to Comply /Summary of Violations have been
corrected. I have, personally examined any documentation attached to the certification to establish that
the, violations have been corrected.
Signature:
Title:
Print Name:
Date.,
KPS #8446
fl--w +„ he wont in nftmr RPtimn -to- Compliance Pink — Prevention Services Copy