Code Enforcement Complaint

2. First Name

3. Last Name

5. Address

7. City

8. State

9. Zip

11. Phone

12. E-Mail

14. Location Address*

16. Description of Complaint*

18. Would you like to be contacted on this issue?*

    1. Yes
    2. No

    Please remember to provide your contact information above if you choose yes.

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20. 1. Receive email copy
21. Email address

    This field is not part of the form submission.

22. Submit

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