E-Gov Services Midland

Sidewalk Repairs

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Use this form to identify a sidewalk repair issue.

* Information is required.

Contact Information

* First Name:
* Last Name:
* Email:
* Daytime Phone:	() –
* Address:

* Please indicate as precisely as possible the location of the sidewalk needing repair:

* Please indicate the nature of the problem:

Trip hazard

Broken walk

Unlevel walk

Other

Additional comments:

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

When you submit information through this form, you will receive a Tracking Number. You can track the status of your request by entering your tracking number in the field provided on the "Services and Information Requests" page

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.