Text Box: NOTE: All citizen complaints must be in written format, once the form is completed please mail or deliver to the Street Department.


Storm Water Complaint Form


Street Department 104 South Park Street, Ellettsville, IN 47429


Date: Parcel Number:






City: State Zip Code


Phone Number: E-Mail Address:


Nature and location of complaint:

(Please write legibly)




Text Box: Notifications and Inspections: Danny Stalcup	       Rick Coppock	      Date: 	
Inspection Findings:

Action Required:

Photos Taken: Yes  or  No