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2. THIS IS NOT THE FORM TO REQUEST PUBLIC RECORDS UNDER THE ACCESS TO PUBLIC RECORDS ACT.  IF YOU'RE REQUESTING INFORMATION UNDER APRA PLEASE GO TO THE DESIGNATED FORM FOR PUBLIC RECORDS.  

4. First Name*
5. Last Name*
7. Phone Number
8. Email Address*
10. Problem Type*
    -- Select One --AnimalDrainage/StormwaterGraffiti Illegal DumpingManhole/Catch BasinParks/PlaygroundsPotholesRecreational FieldsSewerSidewalksSnow/IceStreetlightsStreet SweepingTrash/RecyclingWaterOther

    Please describe the general category that your concern falls under. 

12. Photographs/Documentation

    If you have photos or documentation associated with your concern.

14. Describe the Problem (Please include location)*
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16. 1. Receive an email copy of this form.
17. Email address

    This field is not part of the form submission.

18. Submit

* indicates a required field