Complaint Form

2. First Name*

3. Last Name*

5. Address1*

7. Address2

9. City*

10. State*

11. Zip*

13. Phone Number

14. Email Address

16. Address of Complaint*

18. Description of Complaint*

20. When did the problem start?*

24. Have you talked to anyone about the problem prior to contacting the Building Department?*

26. Description of Conversations

    Please describe your conversation(s) with the person. Please include any times / dates of your conversations.

28. Name of person you spoke to:

30. Phone number of person you spoke to:

32. Email Address of person you spoke to:

Leave This Blank:


33. 1. Receive email copy
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field