Fire Hazard Complaint form
Please provide as much information as you know. If you do not know the information we will do our best to find it. Please provide your information so we can contact you if we have questions about your complaint. Thank you.
Date
MM
/
DD
/
YYYY
Type of Hazard
Hazard property address numbers
Your answer
Hazard property street name
Your answer
Hazard property location/address
Location of hazard on property
ie brush next to the back fence
Your answer
Hazard property owner's name (if known)
Your answer
Hazard property owner's address
(if known and if different than hazard property address)
Your answer
Assessor's Parcel Number (if known)
Your answer
Please describe the specific FIRE Hazard.
Your answer
Reporting party
Your answer
Reporting party address
Your answer
Reporting party phone number
Your answer
Reporting party email address
Your answer
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