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Request for Service Form

In order for Code Compliance to follow-up on a call for service, all the information requested must be provided. Fields that are in bold are required.
Your Information
  Your Name:
  Address 1:
  Address 2:
  City:
  State:
  Zip:
  Telephone #:
  Email Address:
Violation Address Information (max 5 per submission)

(Report violations at additional addresses)
1. Violation Address:  
(eg number 1234) (eg street W Glendale Ave)
Violation(s): (Check all that apply):
Abandoned Vehicles Parking on Unimproved Surfaces
Overgrown Grass/Weeds Weekdays
Outside Storage AM's    PM's
Trash/Debris Weekends
Other AM's    PM's

Description/Location Information
(150 chars or less)

Remaining

(eg red truck parked in front yard by porch steps on weekdays before 6am and after 6pm)

Attachment
   
**Please upload only .BMP, .JPG, .GIF, .PDF, .RTF or .TXT files.
**Photos will only be used for informational purposes in support of an alleged code violation and cannot be used as evidence in a court action.



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