Codes Complaint

2. First Name*

3. Last Name*

5. Address*

   Your Address

7. City*

8. State*

9. Zip Code*

11. Phone Number*

13. Email Address*

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15. Code Violation Address

17. Code Violation Summary

    Please describe the code violation

19. Upload a picture of the violation

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21. 1. Receive an email copy of this form.
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