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2. Please report your concern. Should a problem require urgent attention, please contact City Hall immediately at 708-331-4905. For a police emergency, dial 911.
   Thank you for your assistance.
4. Contact Information
6. First Name
7. Last Name
9. Address1
11. Address2
13. City
14. State
15. Zip
17. Phone Number
18. Email Address
20. Please indicate the nature of your problem by checking the appropriate box(es) below:
22. 1. Pothole
    2. High Grass/Weeds
    3. Stray Animal
    4. Dead Animal on Roadway

    1. Abandoned Vehicles
    2. Derelict Vehicles
    3. Water Main Break
    4. Street Lights

    1. Missing Traffic/Road signs
    2. Storm sewer leaking/blockage
    3. Water leaking on roadway
    4. Other
24. Brief Description (or other problem not listed)
26. Location of Problem*
    Provide a detailed location of the problem identified.
Leave This Blank:


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

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field