Unsanitary / unsafe property		Improper or unapproved use or occupancy
	Trash, junk, debris		Encroachment in public right of way
	Overgrown and / or piles of vegetaion		Hazardous obstruction
	Abandoned / inoperative vehicles		Zoning violation
	Environmental (sewage, chemicals, etc.)		Fencing
	Building code violation		Polluted water
	Substandard housing conditions		Other
	Deteriorated, dangerous, unsafe building(s)

Description of issue(s) checked above:

• All requests are confidential and requester information is destroyed at the conclusion of a case.
• In order for the City to process this request, requester must provide all information requested below.
• The City will not process or respond to anonymous requests.  

First Name:
Last Name:
Address:
City / State / ZIP:	/  /
Home Phone:
Other Phone:
Email: