Code Violation Worksheet

This document is for your records; it is designed to help guide you through the process.. It is also a good way to help you keep track of all the necessary information. Be sure to make separate copies for each violation you are reporting. You may wish to provide a copy to your neighborhood association president.

Address you are reporting:    
Property owner’s name (if available) & contact information:   Tenant’s name (if available) & contact information:
Description of suspected code violation :    
Any actions taken before calling 311:    
Date you reported it to 311:   Complaint number:
Date you called to follow up:   Case number:
Investigator’s name:   Phone:
Additional dates investigator was contacted:  
Additional information that was given to investigator:    
Status of the investigation:    
Estimated date of resolution: