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City of Missoula Date: Building Inspection Division Missoula Lighting Ordinance Complaint Form (Please Print) Violation Number: Property Owner Information Complainant Information Name Address Phone Note: Light bulbs that are 60 watts or less are exempt from the Missoula Lighting Ordinance. Fixture Type: Pole mounted Building mounted Location of fixture: Front yard Rear yard Side yard Alley Street Type of residence: Single family Duplex 3-Plex 4-Plex or more Commercial Please explain how the light affects you: • As the complainant, you are advised that this complaint may necessitate court action, and you may be required to testify to the accuracy of your statements. • I have read and understand these requirements, and, to the best of my knowledge, the above statements are correct. I will be prepared to testify in the event this matter is taken to a court of law. Complainant Signature: