HomeMy WebLinkAboutAlouette River Inspection Request.pdfAlouette River Inspection Questionnaire
City of Maple Ridge – Operations Centre 23925 Dewdney Trunk Road, Maple Ridge, BC V4R 1W1 Tel: 604-463-9581 Fax: 604-467-7360 operationscentre@mapleridge.ca www.mapleridge.ca Alouette
River Inspection Request THE FOLLOWING SHOULD BE FILLED OUT BY THE RESIDENT WITH AS MUCH DETAIL AVAILABLE AND RETURNED TO THE CITY OF MAPLE RIDGE OPERATIONS CENTRE BY EMAIL, MAIL OR
FAX. DATE: __________________________________________________________________ NAME OF RESIDENT: ADDRESS OF RESIDENT: TELEPHONE NUMBER: (DAY) ______________________________ (EVENING)
EMAIL ADDRESS: ________________________________________________________ NATURE OF PROBLEM, HOW IT AFFECTS YOU, AND HOW LONG IT HAS EXISTED: LOCATION OF PROBLEM (GIVE GPS CO-ORDINATE
IF AVAILABLE, ATTACH PHOTOS AND/OR SKETCHES): IS THE PROPERTY OCCUPIED BY THE OWNER OR TENANT? _________________ NAME OF OTHER CONTACTS: NOTE: LOCATING AND ASSESSING PROBLEMS ON PRIVATE
PROPERTY REQUIRES PERMISSION TO ENTER. ARE YOU WILLING TO GRANT PERMISSION FOR CITY OF MAPLE RIDGE REPRESENTATIVES TO ENTER YOUR PRIVATE PROPERTY AND VIEW THE LOCATION? YES NO ARE YOU
WILLING TO SHOW THE PROBLEM LOCATION TO A CITY OF MAPLE RIDGE REPRESENTATIVE? YES NO SPECIAL INSTRUCTIONS: INTERNAL -TO BE FILLED IN BY STAFF ACTION REQUEST CREATED ACTION REQUEST #
City of Maple Ridge – Operations Centre 23925 Dewdney Trunk Road, Maple Ridge, BC V4R 1W1 Tel: 604-463-9581 Fax: 604-467-7360 operationscentre@mapleridge.ca www.mapleridge.ca PHOTOGRAPH
LOG FORM DATE FROM TO DURATION LOCATION AND DETAILS OF PHOTO