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:

 

Name:

 

Address:

 

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:




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