2. First Name*
3. Last Name*
5. Phone Number*
6. Email Address
   Provide email address where we can send a reply.
8. Address1*
   Please provide the address where the concern is located.
10. Department

    1. City Administrator
    2. Code Enforcement
    3. Court
    4. Fire
    5. Police
12. Description*
    Please provide a brief description of the issue you are having.
14. File Upload
    Please attach any photos or documents you might have referencing the issue.
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16. 1. Receive an email copy of this form.
17. Email address

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18. Submit

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