HomeMy WebLinkAboutIncident # 92P0845 (12/09/1991) CITY OF OSHKOSH, WIF'. ?•`!ri 'N' DEPOSIT AS'6ESS COURT- TOTAL
COSTS
UNIFOkrMI MUNICIPAL CITATION COMPLAINT ir r r*
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STATE OF WISCONSIN CIRCUIT COURT BRANCH COUNTY OF WINNEBAGO INCIDENT NO. j FL
THE UNDERSIGNED, AN OFFICER FOR AND IN BEHALF OF THE CITY OF OSHKOSH BEING DULY SWORN, STATES UPON INFORMATION AND BELIEF THAT
THE SAID DEFENDANT DID, ON. E O 1 9i AT HOURS, VIOLATE ORD. NO It?R 41 1 O LV IT:
CITY TTT
OF NAME LAST, FIRST, MIDDLE INITIAL Describe Violation
OSHKOSH vs f A OM A
1i'Y ?Ld.t,t M. ,Vt.MPLI,+JCE WITi Si?
ADDRESS (RESIDENCE) �,CKSON OSHKOSH, APT. NO POST POST OFFICE/ T QJ ZIP
JACKSON CODE FATLURF To FCT C5
t�.K `.7W5�t STREET' ii./ `.X`��, �E� tJ' L. t1 C
PARENT OR GUARDIAN NAME, ADDRESS, PHONE
PHONE AGE BIRTHDATE PLACE OF BIRTH
M F WHT. BLK. NAT. ASN. HSP. NON EYES HAIR WEIGHT HEIGHT
r AM. HSP
LX 1 X 2. 3. 4. 1 2. ON HWY. /STREET PRIVATE /PUBLIC PROPERTY
DRIVER'S LICENSE STATE EXP. SOCIAL SECURITY NO.
AT
[244 jt,f'1,f w'_ S+r P, —"I rt.+1
COUNTY
VEH. PLATE EXP. STATE MAKE YEAR MODEL I COLOR jir°
WINNEBAGO CITY
OF OF OSHKOSH
YOU ARE HEREBY NOTIFIED TO APPEAR IN THE ABOVE NAMED COURT OFFICER'S SI ATURE, NUMBER
ON )y 5 19 f'' AT c, „(1.,`” P.M. SWORN TO BEFORE ME DATE: 'ire 7
LOCATED AT PUBLIC SAFETY BUILDING I 'V, 4 20 JACKSON ST. OSHKOSH, WI 54901 TITLE 1
AGENCY COPY
ARREST
NO.
RECORD
3- y 7 2
DATE OF DISPOSITION STIPULATION ASSESSMENT COURT TOTAL
COSTS
W hdrawn by Agency Reason
;Zoileisdsbeyd Prosecution Reason on
y
PLEA:
7 GUILTY P1 NOT GUILTY ONTEST
FINDINGS:
L NOT GUILTY
SENTENCE:
+COSTS AND /OR
DAYS JAIL AND /OR
H DAYS IN JAIL FOR FAILURE TO PAY:
INCIDENT REPORT:
ORDERS ISSUED TO CORRECT CROSS CONNECTION IN
BATHTUB (FAUCET BELOW FLOOD RIM), A FINAL NO
TICE WAS ISSUED 5/23/91 AND ANOTHER FINAL NO-
TICE WAS ISSUED 12/O2/9 TO NO AVAIL, IN ADD
ITION THE OWNER CONTACTED THE STATE PLUMBING
INSPECTOR, DON KAY, WHO ALSO INFORMED MS, HAR-
WELL THAT THE SITUATION DID IN FACT CREATE A
HEALTH HAZARD AND WOULD HAVE TO BE CORRECTED,
MS. HAR"'ELL PAS INDICATED SHE WANTS TO BE TAKEN
TO COURT TO SOLVE THE f ATTER
SIGNATURE OF OFFICER DATE AND TIME OF INCIDENT REPORT
1/07/92 nOAM