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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. Submissions processed Monday-Friday, 8am-5pm only.

6. Contact Information

8. First Name*

9. Last Name*

11. Address1*

13. Address2

15. City*

16. State*

17. Zip*

19. Home Phone Number*

20. Cell Phone Number

22. Daytime Phone Number

23. Email Address*

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

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

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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

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