Citizen Service Public Works / Street Section

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1) Selected Service Request : Plowing/Salting Requested Snow plowing operations begin when 2 inches of snow has accumulated on the pavement of village streets, salting of village street will take place when conditions exists per policy

2) Provide Details about your Request
Where is Problem: NOTE. IF THE LOCATION OF THE PROBLEM IS THE SAME AS YOUR ADDRESS (or there is no problem) YOU DO NOT HAVE TO FILL IN THESE NEXT TWO FIELDS:
Location
Place Name:

3) Enter your Contact information: Star * = Required Information

	Are You Contacting us as:
	[ an Individual Citizen ] or [ a Business ]
Thank you. PLEASE INTRODUCE YOURSELF:
First Name:*
Last Name:*
Business:
Address: - BREAK YOUR STREET ADDRESS INTO 3 PARTS:
Street Number:*	EXAMPLE [ 134 ]
Street Dir:	EXAMPLE [ NW ]
Street Name:*	EX [ Main St ]
City:	ST: ZIP:
Contact Information : MAKE IT EASY FOR US TO CONTACT YOU.
	[ Home] [ Work]
Alternate Phone:	[ Home] [ Work]
Fax Number:
Your Email:

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