COW Web Citizen PW Water Services Water Requests

Please Enter Information About Yourself

Tell Us About Your Request

Water Maintenance Request Form

FOR OFICIAL USE ONLY

IMPORTANT NOTE !!!!!!!!!!!!!!PLEASE BE ADVISED THAT USING THIS REPORTING FORM SHOULD NOT BE USED TO REPORT EMERGENCIES !IF THIS REQUEST CONCERNS PUBLIC SAFETY, CALL 911 IMMEDIATELY TO REPORT THE PROBLEM !THIS FORM WILL BE READ BY CITY STAFF DURING REGULAR BUSINESS HOURS, M-F, 8 AM - 5 PM.
INSTRUCTIONSBetween the Hours of 8 AM - 5 PM, Please Call 265-1300 for Normal Reporting of Water Maintenance Issues.Please Call 262-6000 for After Hours reporting of Water Issues.A Valid Phone Number & E-Mail Address Must Be Entered in Order for this request to be Processed.All Phone Numbers Should Be In The ###-#### or (###) ###-#### Format Please.
First Name*
Last Name*
Phone #*
Business
Bldg #
Street Name
Apt/Suite #
City*
State
Zip Code
E-Mail Address*
Home Phone #
Work Phone #
Problem*
Click the icon to the right to look up exact street information.NOTE: To filter street information, enter text in the first line, then click the filter button.
Bldg #
Street Name where Request is Desired*
City*
County*
State
Zip Code
Nearest Cross Street Name
PLEASE DESCRIBE THE PROBELM IN DETAILINCLUDE ANY INFORMATION THAT WILL ASSIST CREWS IN LCOATING THE PROBLEMPLEASE BE AWARE THAT YOU MAY BE CONTACTED BY E-MAIL OR TELEPHONE FOR CLARIFICATION
Problem Description*
Category*
Department*
Status*
Supervisor*
Do not click SUBMIT more than once!

Enter the code shown above:
Information