| It is required to enter the City/District listed above | |
| First Name | |
| Last Name | |
| Address | |
| P.O. Box | |
| City | |
| State | |
| Zip Code | |
| Phone Number | |
| Email address | |
| Parcel Number if known | |
| Location of the Violation | |
| Nearest address or cross street | |
| Type of Violation | |
| Can the Violation be seen from a public right-of-way? | YES NO |
| If NO, can the Violation be seen from your parcel? | YES NO |
| Are you willing to meet with an Inspector if needed? | YES NO |
| Comments
| |
| *An Inspector will telephone or e-mail you within 3 business days. | |
