Fillable Minimum Housing Complaint Form Code Enforcement Department (City of Winooski)

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Minimum Housing Complaint Form Code Enforcement Department (City of Winooski)

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Minimum Housing Complaint Form
Code Enforcement Department
Please use this form to record and report code violations or concerns you observe.
Completed forms can be mailed or delivered to Winooski City Hall (27 West Allen Street) or
emailed to: kgaudette@winooskivt.gov & jaudy@winooskivt.gov
Resident Information
Name Mailing Address
Phone Email
Violation Information
Date Time
Property Location
Exterior Property
□ Trash, garbage, furniture or accumulation in the yard
□ Trash, garbage, furniture or accumulation on the greenbelt or sidewalk
□ Overgrown weeds or vegetation encroaching on the right of way
□ Parking on grass or in the greenbelt
□ Unregistered, inoperable or dismantled vehicles
□ Sign or other obstruction placed in greenbelt or right of way
□ Dumpster location, maintenance o Dilapidated fences, garages or outbuildings
□ Other
Exterior Building
□ Defective stairs, porches, or roof
□ Broken or otherwise defective windows or doors
□ Excessive peeling paint or other dilapidated surfaces
□ Furniture constructed for indoor use or other accumulations on porch or stairs
□ Other
Interior Building
□ Defects to electrical, heating or plumbing systems
□ Stairs, handrails, or other egress defects
□ Smoke or CO detectors inoperative or missing
□ Over-crowding, illegal living space in cellar or attic
□ Problems with means of egress
□ Excessive accumulations or storage
□ Other unsafe or unsanitary conditions
Additional Comments
Print Name
Signature Date
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Minimum Housing Complaint Form Code Enforcement Department (City of Winooski)

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Completed 23 March 2021

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