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2. All code violation complaints are kept confidential.
4. Name*
6. Phone Number*
7. Email Address*
9. Address*
11. City*
12. State*
13. Zip Code*
15. Violation

    Please provide a detailed description of the code violation.

17. Do you wish to be contacted by the Code Compliance Officer?*

    1. Yes
    2. No
21. Terms & Conditions
23. Consent*

    1. I certify that what I have stated above and below is truthful to the best of my knowledge.
25. Complainant Acknowledgment*

    Please provide your full name for acknowledgment. 

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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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