Outdoor Light Repair Request
Applicant Information
Enter your Account #
Your account number is listed on your bill
First Name
Last Name
Email
Phone
List the best phone number to reach you during the day
Application Record Type ID
Record Type Name
Light Information
Pole #
Problem Type
Burned Out
Broken Glass
On 24 Hours a Day
Turns On and Off Repeatedly
Other
Describe Other Problem
Street Address Closet to Light
City
Please include any additional information that may assist us in identifying or locating the light outage, including any detailed directions. Also note any access issues, such as a locked gate, dog, trees or shrubs, and access instructions (gate combination, etc.).
Additional Documentation