City Pothole and Roadway Hazard Citizen Report and Repair Request Form
City Pothole and Roadway Hazard Citizen Report and Repair Request Form
Report potholes, sinkholes, or roadway hazards to the public works department for inspection and repair scheduling.
Reporter name (optional) *
Your answer
Contact email for follow-up
Phone number
Hazard type
Approximate size
Estimated depth (inches)
Street address or nearest intersection
Lane location
+ 6 more questions
About this template
Report potholes, sinkholes, or roadway hazards to the public works department for inspection and repair scheduling.
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