Street Repair Request

Use this form to notify the City of a pothole or other street failure.

A street failure includes anything that impairs the normal flow of traffic, such as loose manhole covers, debris in the street or flooding.

• Please submit a separate form for each request.
• Provide as much information as possible about the location of the pothole or street failure.
• Avoid vague descriptions like "One mile west of Carlisle" or "3 lights south of Lomas".
• When listing cross streets, please be exact (i.e., if the street failure is in a residential area, list residential streets as the cross streets, not the closest major intersection).

If you have difficulties with the form, please call 311.

Street Failure Information

Date Observed (Required)

--199920002001200220032004200520062007200820092010201120122013201420152016201720182019 / --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / --12345678910111213141516171819202122232425262728293031

Type of Street Failure

Choose One

PotholeCurb or Gutter DamageCrack in StreetRequest to SweepHump or Dip in RoadUnpaved Road Needs Blading (Smoothing)Snow or Ice on RoadStreet FloodedManhole Cover Loose or RattlingStorm Drain Loose or RattlingValve Cover Loose or RattlingOther (Describe Below in Comments Section)

Address of Street Failure

(If Possible)

Zip Code (Required)

Cross Streets (Required)

One Street Name per Line

Specifics about Location of Street Failure

All of the information in this section is based on the cross streets listed above, so please make sure that the cross streets are accurate!

Where is the Failure?

Choose One

In Crossing
On Street

Where in Crossing?

N/ANW CornerNE CornerSW CornerSE CornerCenter

On which street?

(Must be one of the cross streets listed above)

Please provide a direction of travel towards the street failure.

(This is necessary to answer the questions below)

N/AEastboundWestboundNorthboundSouthbound

Is the street failure before or after the cross street?

N/ABefore : 0-15 feetBefore : 15-30 feetBefore : 30-60 feetBefore : 60+ feet-------------------After : 0-15 feetAfter : 15-30 feetAfter : 30-60 feetAfter : 60+ feet

In Which Lane is the Street Failure?

N/ALeftCenterRightLeft TurnRight Turn

Please List any Nearby Landmarks

Comments (Required)

Your Name

Your Telephone Number

Your E-Mail Address (Required)