E-Gov Services Village of Grayslake

Traffic Signals / Traffic Light

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Purpose. This form is used to communicate with Village personnel to request services. Note: If your request falls under the jurisdiction of another agency, then the Village will forward your request to the appropriate agency for action. We will mark the request as "Resolved" when we have done so.

* Information is required.

Contact Information

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

Traffic Signal / Light Location:

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

* Address:	- Or Other Not Listed -
Unit:

	Provide any additional information on location in the box below.

Desctiption of problem/suggestion

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Notes:

If you send us a message, you'll receive a Tracking Number allowing you to follow-up with your request, at your convenience.

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Internal Use Only, Leave Blank:
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