request a repair or service
Complete form to request service for a Public Works Issue.
All information provided becomes a matter of Public Record and is available upon request. For questions or comments: Contact (321) 952-3437.
Resident Name:
First Name:
Last Name:
Resident Information:
Street Number:
Street Name:
City/State: Palm Bay, Florida
Zip/Postal Code:
Home Phone: xxx-xxx-xxxx
Cell Phone: xxx-xxx-xxxx
Alternate Phone: xxx-xxx-xxxx
Reporting an issue with the following: (check all that apply) Pothole Repair Sign Repairs (for Stop Signs call 321-952-3437) Swale Trenching Request Street Light Request Street Sweeping Nuisance Vegetation Sidewalk Repair Canal Mowing Waste Management Construction Project in Progress Roadside and Median Maintenance To report a power outage or problem contact FPL directly.
Description of Issue: (required field)
Exact Location of issue:
Other areas of concern:
Contact Information: (required field) Public Works will contact you to follow-up on the issue, or to ask additional questions to assist us in processing your request.
All information provided becomes a matter of Public Record and is available upon request. Read Legal Disclaimer for additional information.
Contact E-mail Address:
^Top
