Residential Complaint or Code Violation Form

Your information

Name:
Your Address:
City/State/Zip:
Phone:
Email Address:
College Student? Yes
No
Relationship to Property (owner, neighbor, concerned citizen):

Complaint or Code Violation

Type of Violation: fire safety
garbage
high grass
housing condition
junk vehicle
no heat
no electricity
open burning
over occupancy
parking
sidewalk not shoveled
water related
vermin infestation
other
Description of Violation:
Street Address:
Apt. No.:
Rental Housing: Yes
No