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Citizen Request for Services Form
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This form has been modified since it was saved. Please review all fields before submitting.
Use this form to request or report the following: repair of street or potholes, reporting of hazardous sidewalk condition, street or gutter drainage problems, bike paths and catch basin stoppages, street sign issues, traffic signal outage, streetlight outage (provide streetlight pole number). Your name, telephone number, and e-mail address are not required, but are helpful should questions arise.
Reported location must be within the Town of Plainville boundaries. The exact reported location/site address is required.
Please use one form per request!
Contact Information
First Name
Last Name
Phone Number
Email Address
Street Address:
Exact Location of Job Requested
Street Name, Address or Block Number
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Nearest Two Cross Streets
Nature of Request
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