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PROPERTY MAINTENANCE ISSUE COMPLAINT FORM
This form is for reporting observed Property Maintenance Issues that are interpreted as a potential violation of the IPMC and/or Municipal Ordinances. Areas below that have an * must be filled in to be a legitimate complaint for follow-up.
Address of Proposed Violation
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Poroposed Violation
Rubbish / Trash
High Grass / Weeds on property
Shrubs / trees / bushes encroaching sidewalks
Shrubs/trees/bushes encroaching streets/alley
Unsafe structure(s)
Unregistered Vehicle(s)
Damaged siding/roof
Peeling Paint
Sidewalk
Residential
Commercial/business
Other*
If other is checked, please explain here:
The following information provided below cannot be released to any person other than an authorized municipal representative unless ordered by a court or the complainant agrees in writing.
Note: All information must be completed to accurately respond to this complaint. Be it known that submission of a false statement may be subject to legal actions of the municipality.
Name of complainant(s)
Address of complainant(s)
Street Address
City
State / Province / Region
ZIP / Postal Code
Email
Phone
Do you want contacted with the resolution of the proposed violation?
Yes
No
Date
(Required)
MM slash DD slash YYYY
Δ
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