Citizen Concerns & Inquiries Form

Please fill out the following information and choose the category in "Request Type" which most closely fits your concern.  If there are none, just select "Other" category and type in the "Comments" section what information and/or concern you may have.  The system will generate a unique id/ticket that will be automatically submitted to the appropriate department/staff member.  We will do our best to respond to your concern in a timely manner.  Thank you for using our online Citizen Concerns & Inquiries system.

(*=required fields; if needed, First & Last Name fields can use "anonymous")

Your Information
First/MI.:
*
Last Name:
*
Address:
*
Address 2:
City:
*
State:
*
Zip:
*
Phone:
 Ext.: 
Alt. Phone:
 Ext.: 
Email:
Request Details
City:
Street #:
Street:
*
Cross St:
Request Type:
 *
Comments:
 I would like to be notified by email of updates to this request
 I would like to be notified by phone of updates to this request