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2. 
3. Extension request for Notices of Violation may be approved by staff only if the applicant can prove progress towards correcting the violation(s) listed in the Notice of Violation.
5. Any request for an extension must be submitted to the Neighborhood Services Department no later than five (5) business days prior to the scheduled hearing. The City’s final determination will be based on a number of factors, including but not limited to the following:

   (1) The gravity of the violation(s)

   (2) The length of time and effort it might take to obtain compliance

   (3) The history of code violations at the property in question

9. Name
10. Relationship to the property
12. Address
14. City
15. State
16. Zip Code
18. Phone Number
19. Email Address
21. Nature of the case(s)
23. Case Number
24. Time Requested

    1. 30 Days
    2. 60 Days
26. Reason for request
28. Any supporting documentation

    1. Yes
    2. No

    (If yes, please attach documents)

    It is the responsibility of the property owner to contact the Neigborhood Services Department for a Re-Inspection when the violation(s) have been corrected.

30. Supporting Document 1
31. Supporting Document 2
33. Applicant Name
35. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
37. Applicant Electronic Signature
39. Date
    Date
43. STAFF PURPOSES ONLY

    Neigborhood Services Officer Name: ________________________________

    Date case was opened: ___________________

    Is a recent photo attached? ___________________

    • Support Request  
    • Deny Request  

    Time NSO recommends: 

    • 30 days 
    • 60 days 

    Any prior extensions granted: 

    • Yes 
    • No 

    Are there any other pending violations for this property: 

    • Yes
    • No 

    NSO Comments: 

    
    

    
    

    Officer Signature: ______________________

    Approved by: _____________________________

    Date: _________________

    Extension Given: _____________________________

    Approval denied by: _____________________________

    Date: _______________________ 

    Management Comments: _______________________________________

    Scanned into TCM by: ___________________ Date Owner Notified of Extension:_________________

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45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

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