E-Gov Services Village of Grayslake

Snow Plowing - Mailbox Damage

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Purpose. This form is used to request a mailbox repair by Public Works or request a check in the amount of $50.00 for a new mailbox to be installed by the homeowner.

Note: Depending on the nature of your repair, a permanent fix may not be made until weather permits.

* Information is required.

Contact Information

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

Mailbox Location:

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

* Address	- Or Other Not Listed - Invalid Address The address you entered does not match any in the system. You can select a valid address from the list, or if you are certain the address you entered is correct click the "Use the address I entered" button, to continue. The address you entered
Unit:
	Provide any additional information on the location in the box below.

* Check all that apply:

Make repairs to existing mailbox
Replace damaged mailbox with standard mailbox

Repair damaged mailbox post
Send check for $50.00, I will install a new mailbox

Other information...

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* 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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