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Citizen Work Request

2. Citizen Work Request
   The City of Milton is here to help. For any of the Public Works services listed below, please complete and submit our Citizen Work Request form. Road Surface Concerns: Public Works addresses requests for patching pavement potholes, resurfacing and paving roads, road striping, etc. Right-of-Way: Public Works mows all city-maintained right of ways. Pond Cleaning: Public Works mows, cleans, and clears all city holding ponds. Shoulder & Road Obstructions: Public Works removes Items in the roadway that obstruct the flow of traffic or creates a hazard on the roadway. Trash Removal: Public Works removes litter from all city roadways. Household items like bagged trash should be reported to our Code Enforcement office for investigation. Damaged refuse can-repairs: Public Works repair all City of Milton Sanitation & Recycle cans if needed.
3. 
5. First Name
6. Last Name
8. Date and Time of form submission
   Date and Time of form submission

   Date and Time of form submission
9. Receive a copy of this form
   Email address
11. Address1
13. Address2
15. City
16. State
17. Zip
21. Please provide the location of the concern you are submitting for
23. Please describe the problem you are submitting for, here.
25. Please check all that apply

    1. Road Surface Concerns
    2. Pot Holes
    3. Right of Way
    4. Mowing
    5. Holding Ponds
    6. Shoulder or Road Obstructions
    7. Trash Removal
    8. Sanitation and/ or Recycling Can Repairs
26. Please take a photo of the problem you are submitting for
    Upload your photo here. (please ensure the image is clear and easily identifiable)
28. Can Repairs
    If you need to have something repaired on your sanitation or recycling can, please list it here:
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

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