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Please fill in all information below so that we may better serve you. Required fields are marked by *.

Location of Code Violation (Address)* :

Cross Streets (if known):

Code Violation Description* :

Property Manager:

Street Address:

City:        State:

Zip Code:

Phone:

Property Owner:

Street Address:

City:    State:

Zip Code:

Phone:

Building Use (Dwelling, Apartment, Construction Site, Office, Auto Repair):

# of Units (Apartments) 

Comments:     

 Contact Information: 

Please provide the following information so that we may contact you for any additional information.

Name:

Street Address:

City:

State:

Zip Code:

Phone (day):

Phone (night):

email address:

Best time to reach you:

The Code Compliance Officer assigned to your case will contact you within 10 days.