Fire Hazard Complaint Form

City of Canton Building & Safety Services 110 Academy St Canton, GA 30114

Today's Date * +

Date of incident: * +

Are you a City of Canton Employee? *

Address where the incident occured:

Street: *

City: *

State: *

Zipcode: *

Name of Business or Property: *

Please indicate the nature of the issue: *

Complaint Description: *

File Upload: (images or document evidence)

Note: Providing contact information is not required, however it will assist us if more
information is needed.

First Name

Last Name

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address

City:

Email: