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Public Works Service Request

2. 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.
4. Disclaimer*

   This online form is not monitored after hours or on weekends. If you need immediate assistance, call the 24-hour dispatch line at 425-257-8821.

   1. I understand.
6. Contact Information
   This information will be used to contact you. A contact name, address, email, and telephone number are required.
8. First Name*
9. Last Name*
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Phone Number*
20. Alternative Phone Number
22. Email Address*
24. Location of Service Requested if different than contact address. Please include cross streets and landmarks.
26. Please describe the type of request, problem, or concern:
28. Upload an image
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

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