E-Gov Services City of Melrose

Sand Barrel

Click here to Login | Click here to Register

Purpose. This form is used to communicate with city personnel to request services and request information. Should you have any questions, please contact the Public Works Department at (781) 665-0142.

* Information is required.

Contact Information

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

* Location of barrel?

* Select one of the following:

Refill existing

Add new

Repair existing

Move to new location (specify below)

Additional information?

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

Add Another FIle

CAPTCHA

Check here to have email confirmation of this submission.

* 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.