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2. Name*
   Complaintant Name
4. Confidential Complaint*

   1. Yes
   2. No
6. Complainant Address
8. Street Number
9. Street Name
10. Street Type
11. Apt #
13. City
14. State
15. Zip
17. Phone Number
18. Email
20. Nuisance Category (Select all that apply)*

    1. Sanitary / Health Hazard
    2. Filth / Litter ? Debris / Storage
    3. Junk Vehicle(s) / Parking of Vehicles
    4. Graffiti

    1. Vegetation / Tree(s) shrubs
    2. Right-of-way obstruction
    3. Light trespass / Noise
    4. Interference or damage to Environmentally Sensitive Areas (i.e. bluffs, ravines, wetlands, streams, ect.)

    1. Abandoned / dilapidated structure
    2. Construction Nuisance
    3. Unauthorized / Illegal Sign
    4. Other (Please explain below)
22. Other Nuisance
24. Nuisance Address*
26. Nuisance Description
28. I understand that all public nuisance complaints are prioritized according to the level of adverse impact to public health, safety, and welfare; and that by checking the “confidential” box, I understand that confidentiality, or non-disclosure, relates to Public Records disclosure (RCW 42.56.24) and does not protect my identity in the event of court actions or proceedings.
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

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