E-Gov Services Village of Grayslake

Storm Drainage / Standing Water

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Purpose. This form is used to communicate with Village personnel to request services and information related to storm water drainage or storm sewer problems.

* Information is required.

Contact Information

* First Name:
* Last Name:
Business Name:
Email:
* Daytime Phone:	() –
Fax:	() –
* Address:
City:
State:
ZIP:

Drainage Issue Location (nearest address):

If the address is the same as above, please reenter the address here.

* Address:	- Or Other Not Listed -
Unit:

	Provide any additional information on the location in the box below.

Drainage issue is located...

In the Street

On the Sidewalk / Bike Path

In the Yard

Other

* Description of problem

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

Upon submitting a request, you will receive a tracking number which may be used to follow up with your request at a later date. If an email address is provided, you may choose to receive a copy of your request via email which includes this tracking number.

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Internal Use Only, Leave Blank:
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