Form Center

2. 

3. This is a form that can be used to inform the City of Newton, Iowa of credible complaints against a Commercial Business or Commercial Property.

5. COMPLAINANT NAME:*
6. DATE:*
   DATE:
8. TELEPHONE NUMBER: *
9. EMAIL:
11. PROPERTY ADDRESS:
13. BUSINESS NAME: (IF APPLICABLE)
15. OWNER/MANAGER NAME:
16. OWNER TELEPHONE:
18. OWNER ADDRESS:
20. City
21. State
22. Zip
24. Do you currently conduct business at this address?*

    1. Yes
    2. No
26. Did you register a complaint with the property owner at least 14 days prior to this?*

    1. Yes
    2. No
27. IF SO - WHAT DATE WAS THE COMPLAINT FILED?
    IF SO - WHAT DATE WAS THE COMPLAINT FILED?
29. DESCRIPTION OF COMPLAINT
    Please describe the complaint in full detail including dates and times if pertinent:
30. Upload additional documents here:
    Please attach any additional information, such as pictures displaying problems, communications with the property owner/manager prior to this complaint, and/or any other supporting information.
32. Electronic Signature Required
    By clicking I agree below, I understand that by filing this complaint that the City of Newton will make contact with the property owner or owner's representative to investigate the problem. I also understand that the City will only investigate complaints that are from the current tenants of the property and that the name of reporting tenant is public information and will be released to the owner at the time of notice. The City will make contact with the owner or owner's representative within two (2) business days of the date this complaint is received. I understand that there are some items in which the City may not be able to assist and that in those cases the City will notify me using the contact information provided above. FINALLY, I UNDERSTAND THAT IF THE COMPLAINT IS FOUND TO LACK MERIT, I WILL BE RESPONSIBLE FOR PAYING THE INSPECTOR THE $75 INSPECTION FEE. I certify that all the information on this form is true and correct.
34. Inspection will take place within 10 business days.
36. Do you agree?*

    1. I agree
38. Certification and Electronic Signature
    By clicking I agree below, you agree and acknowledge that 1) Your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature and 3) You hereby certify that you have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction.
40. Do you agree?*

    1. I agree
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit Submit and Print

* indicates a required field