Purpose. This form is used to communicate with township personnel to request services and request information. If there is a utility patch on a Township road that needs repaired you may use this form to notify the township.
* Information is required.
Contact Information
| Please list the location of the utility patch that needs repaired. |
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Check here to have email confirmation of this request sent.
* Information is required.
Notes:
If you send us a message, you'll receive a Tracking Number allowing you to follow-up with your request, at your convenience.
Information we receive may be considered public information which is subject to disclosure under current state law. Learn more about our Privacy Policy.
Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.
