Full Name

Street address

Address (cont.)

City

State

Zip Code

Work Phone

Home Phone

E-mail

Location of Violation

Overgrown Lots/Weeds/Dying Trees

Residential Outdoor Storage/Equipment/Materials/Large Vehicles

Drainage or Erosion Problems/Mud in the Street

Open Burning/Fire during Burn Ban (May 1 - Sept. 1)

Off-Street Parking/Parking on Grass

Trash/Garbage/Dumping

Junked/Dismantled/Abandoned Vehicles

Vehicles Blocking Street or Visibility

Multiple Vehicles/Possible Multi-Family Use

Building Code Violations/Building Without a Permit

Illegal Dumpsters/Garbage Collection Complaint

Street Light Out (please give address(es) below)