Report A Concern

2. Please complete the online form below to submit your complaint. PLEASE NOTE: Do not use this form to report an emergency or potentially life-threatening situation - call 911 immediately!
4. Contact Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip
17. Home Phone Number*
18. Cell Phone Number
20. Daytime Phone Number
21. Email Address*
25. Information About Your Concern
27. Concern Type*
    -- Select One --Damaged Parking MeterPotholeStreetlight OutageWebsite FeedbackOther Issue
29. Closest Address*
30. Pole Number
32. Closest Address*
33. Meter Number
35. Closest Address
36. Location of Pothole*
38. Describe Issue*
40. Upload Photo
41. Additional Information
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field