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2. Do you have a question for us? Or a concern you would like to report? Please write to us here. You may also phone City Offices at 616-527-4170.

6. Contact Information

8. Contact Name*
9. Organization Name (If Any)
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Email Address*

22. Concern / Problem

24. Please Check All That Apply

    1. Street Repairs/Pot Holes
    2. Blocked Storm Sewer
    3. Manhole Cover/Water Cap
    4. Street Light Out
    5. Street Signs
    6. Water Leak on Street
    7. Tree(s) on Berm
26. Other Concern
28. Location

    Street Address or Area of Problem/Concern

32. Questions, Comments, Additional Information

34. Do you have a question, comment, or more information for us? Please tell us how we can be helpful to you. Your information will be directed to the appropriate City department.

36. Questions, Comments, Information
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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

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