COMPLAINT FORM
File/Case #
All fields below are required and must be filled out accurately and completely.
Incomplete complaint forms may be returned until complete information is included.
Your Name: Phone:
Your Address:
Your Email:
Complete Address of Violation:
Assessor Parcel # (if known):
Specific Nature of Complaint (Complete description, including the location of violation on the site. Please
include photos, drawings, Sumner Municipal Code references, and other information as desired.)
Signature: Date:
Official Use Only
Date Received: Received By: Parcel #:
Owner/Occupant Name: Phone:
Mailing Address:
Department Routed To: Building Fire Police Public Works Community Development
Action Taken:
Signature Confirming Action: Date:
Inspector Signature: Date:
COMPLAINT FORM
Print Form