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Code Complaint Form

NOTE: This form works best with Internet Explorer. If you are experiencing difficulty, you may
download the pdf version of this form and mail it to:

County of Santa Cruz - Planning Department
Attn: Patty Moreno
701 Ocean Street Room 400
Santa Cruz, CA 95060

Please complete all sections of this form. You may be contacted for more information about the alleged violation.

The identity of anyone reporting code violations is kept confidental and is protected under california government code section 6250 et. seq. the information will remain confidential. We do not respond to anonymous complaints.

If you would like to attach photos of the alleged violation, please send them to codecompliance@co.santa-cruz.ca.us

Reporting Party Confidential Information

Your personal information is STRICTLY CONFIDENTIAL, however we require all fields to be complete before we accept a complaint.

First Name:

required

Last Name:

required

Address 1:

required

Address 2:
City:

required

State:

required

Zip Code:

required

Primary Phone:
555-555-5555

required

Secondary Phone:
Email Address

required

Location of Violation

The parcel number where the alleged violation is occurring is required for your inspection to be processed. If you are unaware of the parcel number, click here to determine it.

Parcel Number
(no dashes):

required

Property Owner:

required

Address of the violation:

required

Cross Street:

Description of the violation

Please describe in detail the extent and location of the violation selected above:

required

Is this an urgent situation that is creating an immediate hazard?

Yes No

required

If Yes, please explain:

In your judgement, is there cause for concern for the safety of our personnel when they inspect the property or contact the occupant to investigate our complaint?

Yes No

required

If Yes, please explain:

Has the Sheriff or other enforcement agency responded recently?

Yes No

required

If Yes, please explain:

What steps have you already taken to resolve this problem?

required

How is this violation detrimentally impacting you?

required

Letter

Upon receipt of your complaint, the County will send written notification to the owner of the property where the violation is alleged to exist. Do you wish to receive a copy of this letter?
Yes No

required

Please note: some violations are handled by other govermental agencies or departments. Please contact the agencies or departments listed below for the following:

Issue	Agency / Department	Phone Number
Abandoned Vehicles	County Sheriff's Department	454-3139
Animal Control	County Animal Control	454-7303
Drainage	County Public Works Department	454-2160
Septic Tank Failure	County Environmental Health Services	454-2022
Substandard Housing Conditions	County Environmental Health Services	454-2022
Weed Abatement	Local Fire Department	^* varies per local fire department

Confirmation

I certify that the information above is accurate to the best of my knowledge:

required