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2. Complainant Information
4. First Name
5. Last Name
7. Phone Number
8. Email Address
10. Complaint Information:
12. Address or Location of Complaint*
14. Type of Complaint:*
    -- Select One --GrassTrashVehiclesChickensSignsHome OccupationsAccessory StructuresMobile RestaurantOther
15. Do you have a photo you want to submit?
17. Brief Description of the Complaint*
19. How would you like to be contacted back?

    1. Email
    2. Phone
    3. Don't contact me back
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit Submit and Print

* indicates a required field