E-Gov Services Town of Mooresville

Pothole

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Purpose. Use this form to report a pothole.

* Information is required.

Contact Information

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

* Size of pothole

Small (less than 12 inches across)

Medium (12-24 inches)

Large (over 24 inches)

Special Circumstances

Is creating traffic hazard

On major street

Road surface material

Where did you notice the problem?

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

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