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2. For an Emergency Call
   • Electric: 540-375-3030
   • Water and Sewer: 540-375-3029
   • Other: 911
4. Please indicate the problem by marking the appropriate item*

   1. Power Outage-Non Emergency
   2. Pothole / Street Defects
   3. Illegal Dumping Report
   4. Street Light Outage
   5. Street Cleaning Request
   6. Street Sign Request
   7. Dead Animal Removal
   8. Traffic Signals-Non Emergency
   9. Sanitation Code Violation

   1. General Flooding
   2. Water Service Issues
   3. Sewer Service Issues
   4. Zoning Enforcement
   5. Code Enforcement (High grass, Inoperable Vehicle, etc.)
   6. Stormwater pollution (illicit discharge, improper disposal, spill, etc.)
   7. Land disturbing activity complaint (ex. Construction site runoff)
   8. Website Issues
   9. Other (provide details)
6. Brief description (or other problem)
8. Location of Problem (nearest cross street)*
10. Your Name*
11. Your Phone Number
13. Your Home Address*
15. Your Email Address*
16. Please Confirm Your Email Address*
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

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