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2. Today's Date*
   Today's Date
4. Violation Address*
6. What is the type of problem at the address?*

   1. Grass
   2. Trash
   3. Disabled/Unlicensed Vehicle(s)
   4. Sign(s)
   5. Zoning (i.e. sheds, fences, etc.)
   6. Other
8. Where on the property does the violation exist?*
10. If unable to see from road affronting property, do we have permission to enter Complainant's property to view violation?*
    -- Select One --YesNo
12. Complainant's Name*
14. Complainant's Phone Number*
16. Email Address*
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18. 1. Receive an email copy of this form.
19. Email address

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20. Submit

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