Fillable Code Compliance Complaint Form (City of Rollingwood)

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Code Compliance Complaint Form (City of Rollingwood)

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Please send the completed form to: ccaylor@rollingwoodtx.gov
Any information contained on this complaint form may be subject to a FOIA –
Public Information Request
Code Compliance Complaint Form
This form is intended to document City of Rollingwood Code Compliance concerns and ensure
proper follow-up is conducted by appropriate personnel. Thank you for your interest in City of
Rollingwood Codes, and we look forward to resolving your concerns.
Date of Complaint: ______________________________
Complainant Name: ____________________________
Complainant Address: ___________________________
Complainant Phone: (______) ________-____________
Complainant Email: _____________________________
Address of Complaint: _______________________________
Nature of Complaint:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Resolution Requested by Complainant: ________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Office Assigned
Tracking # _______
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Code Compliance Complaint Form (City of Rollingwood)

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Completed 16 July 2020

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