Date *

MM

DD

YYYY

Address of problem site *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do we have permission to access your property (if necessary) to view the violations? *

Please note that our Ordinance Officers CANNOT trespass to verify a complaint. If the complaint involves an item or portion of the property NOT visibile from the roads, our officers will require permission to access your property to view it.

Yes

No

Would you like to be contacted after we respond to the problem site? *

Yes

No

If yes, please provide your contact information.

If you would like to be reached, please leave your name, number and email address in the fields below so we may contact you. Please note that if you leave your information, any information submitted on the website is subject to FOIA.

First Name

Last Name

Your Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Your Phone Number

(###)

###

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