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2. 
4. Complainant Information
6. First Name*
7. Last Name*
9. Email Address*
10. Phone Number*
12. Address1*
14. Address2
16. City
17. State
18. Zip*
20. Location of Potential Violation (Address):*
22. Description of Request*
24. NOTE: Anonymous requests will not be processed. All requests become a matter of public record. The Village is subject to the Public Records Law of the State of WI and therefore may be required to disclose this document in response to a public records request.
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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

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