Forms • Street Light Outage

Brief Description*

What type of problem are you reporting? *

	Single light out
	Multiple lights out
	Light cycling on and off
	Light flickering
	Light on during daylight hours

	Broken glass
	Open/broken or missing light fixture
	Damaged pole
	Exposed wires
	Lights blocked by trees

Problem Location

Street Number and Name:*

*

City:*

State:*

Zip Code:

Photograph:

Your Information

Name:*

Street Number and Name:

City:

State:

Zip Code:

Phone Number:*

Email Address:

Preferred Contact Method:*

* indicates required fields.