Citizen Request Form

Use the form below to report the following issues which will generate a service request to Public Works:

• pothole

• watermain leak/break

• dead animal on the roadway

• sewer blockage

• ditch blockage

• damaged mailbox caused by snow plows

Please be as specific as possible regarding location, to include exact address if possible.

If this is an emergency situation, do not use this form, but call Public Works at (440) 490-2094 during business hours (M-F, 7 a.m. to 3 p.m.); after hours call the Police Department at (440) 490-2001.

Name

Address

Phone Number and/or E-mail Address

Please select from the drop down list the issue you are reporting today.

Please provide exact location of the issue you are reporting and any additional details pertinent to your concern.

To validate your submission, please type the answer to the question.