Citizen Service Public Works / Engineering Division

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1) Selected Service Request : Filling Complaints Reports of filling or grading activities which may result in adverse drainage impacts to adjacent properties? Note: A building permit is required to conduct these activities. Consider the following: Is a valid building permit visible at the construction site? For illegal dumping, try to get a vehicle description, license plate number, and company name and note the date and time. This will assist the Village to identify the dumpers.

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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