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2. Please complete all applicable information and return to the below address. You will be contacted if additional information is required. Response time will vary according to the workload. Please provide as many relevant details as possible including the specific address.
4. Reported Violator's Name:
5. Phone:
7. Violation Site Address:
9. Violation Parcel #:
11. Builder/Contractor Name:
13. Complaint is regarding (check applicable box):

    1. Building
    2. Stormwater
    3. Planning/Zoning
15. Description of Violation:
17. How long has the violation existed?
19. Attach picture if available:
20. Attach picture if available:
22. Other Evidence:
26. Official Use Only:
28. Employee taking Complaint:
29. Date:
    Date:
30. CV#:
34. NOTICE OF INFORMATION DISCLOSURE NOTICE:

    The procedure regarding the disclosure of information contained in code files to the public under the Idaho Public Records Act, Title 74,Chapter 1, Idaho Code (IPRA), shall be as follows:
    1. During the initial investigatory stage, the code violation file will be treated as exempt from disclosure under IPRA.
    2. Once a notice of violation or stop work order has been issued, the contents of a code violation file shall be disclosed to the general public upon receipt of a public records request for that information with the exception of complainant information. Complainant information shall be treated as exempt from disclosure under IPRA while the case is active.
    3. The contents of a closed or inactive code violation file shall be disclosed to the general public upon receipt of a public records request for that information, including complainant information.
    4. Judicial or administrative process (including,without limitation, subpoenas, discovery requests in cases where the County is a party, orders of a court or administrative tribunal, etc.) shall be complied with even if information is exempt from disclosure under IPRA. If there is reason to believe that such a process is defective, the Director will consult with the Prosecuting Attorney to determine whether a motion to quash or other action should be pursued.
    5. EXCEPTION: Under certain circumstances, and only as approved by the Director or Board of County Commissioners in consultation with the Prosecuting Attorney, information in a code violation file may be disclosed on a case-by-case basis even when such information would not ordinarily be disclosed to the general public.

36. Complainants Name
38. Phone:*
39. Email Address:*
41. Complainants Address:
43. Electronic Signature Agreement*

    1. I Agree
    2. I Do Not Agree

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

45. Electronic Signature *
49. Official Use Only:
51. Employee Taking Complaint:
52. Date:
    Date:
53. CV #:
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field