SANTA ROSA COUNTY GOVERNMENT

Complaint Form

Only complaints appearing to be a violation of the Santa Rosa County Land Development Code, a Santa Rosa County Ordinance or the Florida Building Code will be investigated. Quality of work is not under the authority of this Department.

NOTE - If you wish to remain anonymous, do not enter identifying information on the complaint form, but please understand that lack of contact information may impede our investigation.

Contact Information

Your Name:

Your Address:

City:

Zip Code:

Phone Number:

E-mail:

Are you represented by legal counsel?

Yes | No

If yes, please provide attorney's information::

Violator's Information

Violator's Name:

*Address:

*City:

Zip Code:

Phone Number:

Property Owner's Information (If different from violator)

Owner's Name:

Owner's Address:

City:

Phone Number:

Compliant Information

*Location or Address of Complaint or Violation:

*Description of Complaint or Violation:

Attach Picture

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Attachment 1:

Attachment 2:

Attachment 3:

Attachment 4:

Because of Statute of Limitations, please do not delay in consulting with an attorney or initiating any actions to preserve your civil remedies in this matter. The Department cannot be your legal Representative. Matters which involve monetary recovery or questions of restitution for damages are civil in nature and should be addressed to the court with appropriate jurisdiction.

Florida Statues 837.06, False Official Statement: Whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his official duty shall be guilty of a misdemeanor of second degree.

NOTE - If you wish to remain anonymous, do not enter identifying information on the complaint form, but please understand that lack of contact information may impede our investigation.

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