Complaint Form

2. Complainant's Name

   Leave blank if anonymous.

4. Address

   Leave blank if anonymous.

6. City

7. State

8. Zip Code

10. Phone Number

    Leave blank if anonymous.

14. Address / Location of Complaint*

16. City*

17. State*

18. Zip Code*

20. Phone Number

22. Code Enforcement Complaint Description*

24. Date
    Date

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field