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Public Works Service Request

2. Contact Information
   This information will be used to contact you. A contact name, address, email, and telephone number are required.

   This information will be used to contact you. A contact name, address, email, and telephone number are required.

4. For immediate assistance please contact our 24-hour emergency number at 425-257-8821. The email account this service request is delivered to is not monitored 24 hours per day.

6. First Name*

7. Last Name*

9. Address1*

11. Address2

13. City*

14. State*

15. Zip*

17. Phone Number*

18. Alternative Phone Number

20. Email Address*

22. Location of Service Requested if different than contact address. Please include cross streets and landmarks.

24. Please describe the type of request, problem, or concern:

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field