Nuisance Abatement Complaint Form

Please fill out the form as completely as possible. Missing information could result in the inability to confirm the existence of a violation. A street address is preferred and allows us to check pertinent information prior to making a field inspection,

ADDRESS OR LOCATION OF VIOLATION

Owners Name (if known)

Address of location of nuisance

If the address is not known, please explain the location of the nuisance:

If other, Please Explain:

DESCRIBE THE VIOLATION

YOUR INFORMATION

This information is required and is necessary so that we may contact you with any question regarding your complaint. We will not give out this information during the investigation of complaints. Please advise if you do not want to be contacted.

Your Name

Your Address

Your Phone Number

I would like to be contacted for followup

Yes

Contact by email only