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2. INVOICE NUMBER (ON BILL)*
3. PROPERTY ADDRESS*
5. PROPERTY OWNER*
6. OWNER'S DAYTIME PHONE NUMBER*
8. OWNER'S ADDRESS*
10. CITY*
11. STATE*
12. ZIP CODE*
14. E-Mail*
15. Documentary Evidence
17. REASON FOR APPEAL*
19. For proper consideration of this appeal by the City, all of the above fields must be filled out. Attach any documentary evidence with this appeal form to supplement your appeal. (Example: a copy/record of a phone call to the City, an invoice copy for work by a lawn service company, photograph(s) of the property, etc.) If you have already spoken with someone at the City regarding this matter, please provide the date of that contact and the staff person's name. The completed appeal form must be received by the City within 10 days of the date on the invoice. Your appeal will be considered and ruled upon in writing by the City within 10 days of receipt of this completed appeal form. The written response will be sent by mail to the address of the property owner as listed above.
21. For internal purposes only.
    Date appeal received: ______________ Ruling issued: _________________________ Date: _____________
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field