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MARCH 2018 NOR'EASTER
REPORT A ROAD CLOSURE, DOWNED TREES
AND WIRES TO THE COUNTY

WE THANK YOU IN ADVANCE FOR YOUR ASSISTANCE

NAME:          DATE:

MAY WE CONTACT YOU IF NEEDED?

EMAIL ADDRESS:   

CELL PHONE #: 

HOME PHONE #: 

ROAD NAME:  

APPROXIMATE STREET ADDRESS:

MUNICIPALITY:

PLEASE CHECK ALL THAT APPROPRIATE SELECTIONS AND DESCRIBE BELOW IN DETAILS:

DOWNED POWER LINES/WIRES          DOWNED UTILITY POLE(S)          DOWNED TRANSFORMER BOXE(S)

DOWNED TREE(S) ON ROAD          LOW HANGING POWER LINES/WIRES

DETAILS: Please describe as best you can location, intersections, near by road names, landmarks and any other details that may be beneficial: 

Click the SUBMIT button to the left to complete your form. 

 

 

 

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