Name (first and last)

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1. Name (first and last)

What is your street address?

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2. What is your street address?

What is your telephone number?

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3. What is your telephone number?

Address of concern or Code violation

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4. Address of concern or Code violation

Please describe the concern or violation:

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5. Please describe the concern or violation:

do you have pictures? If yes, email them to: ahurtado@calcityfire.us along with an address

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6. do you have pictures? If yes, email them to: ahurtado@calcityfire.us along with an address

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