EmailMeForm
Brunswick Service Department Action Request Form
We are pleased to provide this easy way to submit your requests to the City of Brunswick Division of Service. Be sure to complete all fields below so we have the necessary information for action.
Please select the type of problem you wish to report from the drop down list...
*
Please select
Catch basin/manhole
Ditching
Drive pipe/culvert replacement
Pothole
Sinkhole
Snow plow damaged mailbox
Street light out/flickering
Street sign down or missing
Water main leak, tree lawn or street only
What is the location of the issue?
Please select
At my home address
At the address specified below
Name of person submitting request
*
First
Last
Address of person submitting request
*
Address of problem reported if different from home address
Phone of person submitting request
*
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Email of person submitting request
*
