City of Monterey Accessibility | ADA Accommodation Request or Complaint Form

John Kuehl
Chief of Inspection Services/Building Official, ADA Coordinator
email

Mailing Address:
Permits & Inspections Office
580 Pacific Street, Room 4
Monterey, CA 93940
831.646.5642
Fax: 831.646.5643

Mon. – Thurs.
Open: 7:30 - noon & 12:30 - 4 p.m.*
Closed: noon - 12:30 p.m.

Friday
Open: 8:00 - noon & 12:30 - 4 p.m.*
Closed: noon - 12:30 p.m.
*Available by phone until 5 p.m.

You may be looking for...

Website Accessibililty
Website Accessibility
ada.gov
ada.gov
ADA Request for Accomodation/Complaint Form
ADA Request for Accomodation/Complaint Form


ADA Accommodation Request or Complaint Form ADA Title II Program	Form also available in: MS Word Adobe PDF Return to Accessibility Home Page

Name of person making the request

Date of request

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Address

City

State

Zip

Telephone

Person needing accommodation if other

Telephone of other person

Other contact information

Accommodation

Barrier Removal

Accommodation needed or location of barrier

Brief statement of why this request is being made

Date accommodation is needed

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Time:

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Signature

Date

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Security Code

Enter the code shown above in the box below

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ADA Title II Program

MS Word Adobe PDF