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  • Any personal information you provide is only used to contact you for clarification of the information you report and to provide follow-up on the action. If your complaint is regarding water, sewer, trash or maintenance issues, please, call the office at 304.799.4315 immediately and speak with staff. All other issues, please, continue to fill-in information so your concern can be acted upon.
  • LOCATION OF CONCERN
  • DESCRIPTION OF THE CONCERN
  • Renter reporting unsafe or unhealthy conditions, please provide contact information for the property owner:
  • The Town of Marlinton will process every report received through this form. If another agency is responsible for the issues, it will be forwarded accordingly. To inquire to the status of your report, after three business days, please contact the Town at 304.799.4315.
  • Official Use Only

    DO NOT FILL OUT BELOW THIS POINT
  • Received by: ____________________________________ Date ______

    Property Owner Verified As _________________________________

    Concern forwarded to:
    Administration ___
    Buildings ___
    Police ___
    Maintenance ___
    Flood Plain Coordinator ___
    Outside agency, if so who (give contact information for follow-up) _________________________________

    Follow-up action taken: (Use blank sheet of paper for further reporting or documentation and attach to this report.)

    Case closed: Yes ___ No ___

    By whom?____________________________________ Initials _____

    Date ______

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