2. Reminder
   Filing a false report is a crime and may be subject to prosecution. Enter the complaint location information below and please provide as much information as possible to ensure that our Code Officer is able to assist in your complaint.
4. Address
5. Address 2
7. City
8. State
9. Zip Code
11. Problem Type
13. Specific Details of Problem
15. Please fill in this section if you wish for us to contact you. This is entirely optional and will not affect our intent to assist/investigate any complaint. Please be assured that any information that you provide will be kept in the strictest confidence and will never be shared with outside parties.
17. Contact Information
    First Name
18. 
    Last Name
20. Daytime Phone Number
21. Email Address
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23. 1. Receive an email copy of this form.
24. Email address

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25. Submit

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