2. First Name:*
3. Last Name:*
5. Email Address:
7. Address:
9. City, State, Zip:
11. Type of Complaint:*

    1. Illegal Dumping
    2. High Grass, Weeds, Brush
    3. Junked Vehicles
    4. Parking
    5. Signs in the Right of Way
    6. Other
13. Address of violations (if an address is not known, please indicate location of nearest cross street)*
15. Description of Violation*
17. Upload Photo (if applicable):
    You may upload a photograph of the violation if you have one. By uploading images you agree that the City may use the images for whatever purposes it sees fit. The Town cannot guarantee that images will be reviewed or relied upon by its investigators.
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19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

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