Street Light Repair Request

If you need to request a repair to a street light, please complete the form below. All fields are required.

STREET LIGHTS MUST BE MARKED FOR COMPLETION OF REPAIRS
Light Information:
Number of Lights Needing Repair:
Location of Light(s)/ID Number(s):
Reason for Repair:
Exposed Wires: Yes      No
Lights Marked: Yes
Site Name:
Name of Contact at Site:
Phone # of Contact at Site:
Responsible Party Information:
Contact Name:
Street Address:
Apartment Number:
City
State:
Zip Code
Email Address:
Phone Number:
 

By submitting this form, you indicate you have read and understand the above information.
Please allow up to 2 weeks for completion of repairs.