Service Request Form "*" indicates required fields This field is hidden when viewing the formCitizen Portal Request IdentifierYesThis field is hidden when viewing the formTitleThis field is hidden when viewing the formStatusNewOpenIn ProgressClosedOn HoldIssue Type*Abuse of City VehicleBuilding MaintenanceCustodialCode ViolationGraffitiMosquito SprayParks – Clean UpParks – Repair FacilitiesParks – Repair SprinklerSolid Waste – Deliver PolycartSolid Waste – Go BackSolid Waste – MaintenanceSolid Waste – Remove PolycartSolid Waste – Replace PolycartSolid Waste – Special PickupSolid Waste – Update InfoStreets – Bags of LeavesStreets – Clean Storm DrainsStreets – CleanupStreets – Fence RepairStreets – Grade RoadStreets – HazardStreets – LightsStreets – Paint LinesStreets – Pavement PatchStreets – PotholesStreets – Sidewalk RepairStreets – Sign InstallStreets – Sign RemovalStreets – Sign RepairStreets – Special Pick UpStreets – Street RepairStreets – Sweep RoadStreets – Tree TrimmingStreets – Weed SprayStreets – WeedsStreets – Weeds in AlleyStreets – Weeds on SidewalkWater – BreakWater – Change MeterWater – Check Line For LeaksWater – Check Meter BoxWater – Exessive Standing WaterWater – Fire Hydrant LeakWater – Install MeterWater – Meter IDWater – Missing LidWater – Pavement PatchWater – Replace Meter CanWater – Re-read MeterWater – Sewer BackupWater – Sewer OdorWater – SinkholeWater – Straight ConnectWater – Water OffOtherCode Violation TypeAccumulation of GarbageAnimal RestraintAnimal Running at LargeCampaign SignsLivestockPublic NuisanceRecreational VehicleSignsWeeds & LeavesYard SalesPark9/11 Memorial ParkAnna Becker ParkCorazonDoodle BuggEagle ParkJose Gallegos ParkRosedale ParkVivian FieldsLicense Plate or Vehicle NumberVehicle DescriptionCheck the Damaged Items Curbs/Sidewalks Sprinkler Litter Field Damage Fencing Restroom Lights Hazardous Pothole Sewer Playground Other Other Damaged Item DescriptionDescription of the IssueDate and Time of OccurrenceThis field is hidden when viewing the formAddress_NOTSAVE Address_NOTSAVE City_NOTSAVE State_NOTSAVE Zip_NOTSAVE AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country_NOTSAVE Type the address of the issue in the field below. Google will display a list of matching addresses as you type. Use the down arrow key and press the enter key for the correct address.Address of the Issue Tap/click the Pin in the address to get your current location.Skip past the mapThis field is hidden when viewing the formGeocoderThis field is hidden when viewing the formCoordinatesMap Take/Upload Picture Drop files here or Select files Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 20 MB, Max. files: 10. Tap/click Select Files to take or upload a picture.This field is hidden when viewing the formDisplay On Public Web Site?YesNoIf Yes, only Issue Type, Description, Status, Location and Date will be displayed. This helps other people know that someone else has already submitted the issue.Would you like to be Contacted?YesNoName*Phone*Contact Address* Street Address Address Line 2 City State / Province / Region Email An email address is required if you would like to be updated when the status changes.CAPTCHAUpdated MM slash DD slash YYYY InstagramThis field is for validation purposes and should be left unchanged. Δ