NUISANCE COMPLAINT

Avoyelles Parish Police Jury
Litter Abatement Program
312 N Main St.
Marksville, LA 71351
Ph. 318-253-7291
Fax: 318-253-9218
OFFICIAL NUISANCE ORDINANCE COMPLAINT
Date

MonthDayYear
Date
I am requesting an investigation regarding a possible violation of the Avoyelles Parish Nuisance Ordinance located at:
Under the ownership of:
Nature of complaint: (be specific)
Directions to site:
ANY CONCERNS THAT SHOULD BE BROUGHT TO OUR ATTENTION FOR THE SAFETY OF OUR OFFICER?

YESNO
IF YES, PLEASE SPECIFY:
ANONYMOUS COMPLAINT? (If no, please continue the form.)

YESNO
Name of Complainant/ Title/Office
Office of Complainant
Address/ City/ State/ Zip
Phone Number
E-Mail Address
I understand that I may be called to testify in a court of law regarding the above-mentioned matter.
Signature

Clear
Should be Empty: