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Code Violation Report Form

2. CODE VIOLATION FORM

4. Thank you for filling out our Code Violation Reporting Form. Please provide as much information as possible.<br><br> For questions, contact the Code Enforcement Officer at 913-722-2600 or <a href="mailto:wholtkamp@roelandpark.org.">email the officer</a>.

   Thank you for filling out our Code Violation Reporting Form. Please provide as much information as possible.
   
   For questions, contact the Code Enforcement Officer at 913-722-2600 or email the officer.

6. First Name

7. Last Name

9. Address

11. Phone*

12. Email*

14. Address of the Violation

16. General Location of the Violation *

    Please try to describe the general location of the issue (side of street - north, south, east, west - or major intersections, such as 55th and Roe).

18. Description of the Violation*

20. Do you wish to be contacted after the Code Enforcement Officer completes the investigation?*

    1. Yes, please contact me.
    2. No, please do not contact me.

Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field