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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*
14. Address*
16. City
17. State
18. Zip
22. Date of Complaint
23. Case Number
25. Complaint Received

    1. Office Visit
    2. Phone

    1. Other
26. If other, please explain

28. Action Taken
30. Date
31. Report
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57. 1. Receive an email copy of this form.
58. Email address

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59. Submit Submit and Print

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