Requester's Name


Requester's Company (If Applicable)


Requester's Phone Number


Format: xxx-xxxx (include hyphen)

Requester's Email


Physical Address of Building


Type of Building


i.e. Fire Alarm, Foster Home, Group Home, Daycare, Fireworks, etc.
Notice: In an effort to prevent Spam form submissions, you will need to answer the question what is 2 + 3 ?
Enter result in the field below to submit your request.

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Under North Carolina law, e-mail addresses are public records.
If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact the office by phone or in writing.

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