Fix It Form - Public Works Service Request

2. Submit a maintenance request for street light issues, minor street, signage, sidewalk, or curb and gutter repairs, water system and storm water system maintenance needs.

   Submit a maintenance request for street light issues, minor street, signage, sidewalk, or curb and gutter repairs, water system and storm water system maintenance needs.

4. Contact Information

6. First Name

7. Last Name

9. Location of Concern*

   Please be specific, and give any cross streets if known. Pole numbers on street lights are also helpful.

11. Phone Number*

12. Email Address*

14. Please indicate the nature of your problem by checking the appropriate box(es) below:

16. 1. Pothole or Road Condition
    2. Damaged Curb / Sidewalk
    3. Traffic Signals

    1. Culinary Water Maintenance
    2. Road Striping
    3. Drainage Issue

    1. Street Light Issue
    2. Signage Issue
    3. Overhanging Trees / Shrubs

    1. Loose / Protruding Manhole Cover
    2. Street Sweeping
18. Brief Description (or other problem not listed)

Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit Submit and Print

* indicates a required field