2. Please complete the form below to submit a complaint.
4. Date of Complaint *
   Date of Complaint
6. Reporting Party Information
8. Name:
10. Mailing Address
12. City
13. State
14. Zip
16. Phone Number:
17. Email Address:
19. Location of Violation
21. Street Address*
23. City
24. State
25. Zip
27. Owner and/or Occupant Information (if known):
29. Nature of Complaint:*
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33. 1. Receive an email copy of this form.
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