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2. City of Flagler Beach
   Code Enforcement Alleged Complain Form
4. Alleged Violation Address
6. City
7. State
8. Zip
10. Description of Alleged Violation
12. Person Filing Complaint (First and Last Name)*
14. Address*
16. City
17. State
18. Zip
20. Email*
21. Phone number*
25. Date of Complaint
26. Case Number
28. Complaint Received

    1. Office Visit
    2. Phone

    1. Other
29. If other, please explain

31. Action Taken
33. Date
34. Report
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60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

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