Complaint Form

Name(Required)

First Last

Date(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Type of Complaint(Required)

Zoning Violation

Blight

Road Problem

Drainage Problem

Other

If "Other" Please Clarify

Brief Description of Complaint(Required)

Address or Location of Complaint(Required)

Street Address or Title (Include Owner's Name) State / Province / Region ZIP / Postal Code

CAPTCHA

Riley Township