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General Inquiry / Request for Service / Complaint Form

2. Use this form to submit questions, identify an issue, or report a concern. Your request will be reviewed by city Public Works staff during regular business hours.
   Issues may include: streets, including regulatory signage, and city infrastructure *Please contact Clark Public Utility District regarding street lights.

   Issues may include: streets, including regulatory signage, and city infrastructure *Please contact Clark Public Utility District regarding street lights.

4. Contact Information

6. First Name*

7. Last Name*

9. Address1*

11. Address2

13. City*

14. State*

15. Zip*

17. Home Phone Number*

18. Cell Phone Number

20. Daytime Phone Number

21. Email Address*

23. Please Specify General Inquiry, Request for Service or Complaint*

25. If you have a picture or document that might assist us with your request, you may upload it here.

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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

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