E-Gov Services City of Lockport

Restoration Request

Purpose. This form is used to communicate with city personnel to request repair services, i.e., replace mailbox due to plow damage, restore parkway due to water main break or plow damage, etc.

* Information is required.

Contact Information

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

Issue/Problem Location:

* 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 problem location in the box below.

* Subdivision name.

* What ward is this in?

Ward 1

Ward 2

Ward 3

Ward 4

Do not know

* Description of damage and area needing to be restored...

Attach a Picture or File (max size: 30MB):

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* Information is required.

Notes:

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

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