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Service Request Center

2. Please use this form to request assistance from the city. You may also visit the Customer Service Center in the Municipal Building at 700 N Jefferson, Monday through Friday from 8 am to 4:30 pm, or call us at 785-238-3103.

   Please use this form to request assistance from the city. You may also visit the Customer Service Center in the Municipal Building at 700 N Jefferson, Monday through Friday from 8 am to 4:30 pm, or call us at 785-238-3103.

4. Name*

6. Email*

7. Phone

9. Address

11. City

12. State

13. Zip Code

15. Area of Concern
    Select One:

    Select One:

17. Blights
    -- Select One --Animal Waste SmellDilapidated StructureGraffitiJunk in YardTall Grass / Weeds

18. Sanitation
    -- Select One --Appliance Pick-upMissed TrashPoly Cart IssueSpecial Trash PickupTrash Pickup

19. Sewer
    -- Select One --Grease Trap InspectionLift Station IssueSewer BackupsSewer Line Issue

20. Streets
    -- Select One --Alley IssueDowned TreesFaded CrosswalksPot HolesRoad KillRough and Bumpy PavementStorm DrainStreet CleaningStreet FailureStreet FloodingStreet LightsStreet Lines FadedStreet SignsTraffic LightsUneven StreetsUnmarked Dips

22. Vehicles
    -- Select One --Abandoned VehicleBoats or Trailers Parked in StreetIllegal ParkingParking on Grass

23. Water
    -- Select One --Broken Water Meter LidsDirty WaterLeaking Water MeterLeaky HydrantLow Water Pressure

24. Other
    -- Select One --Loud Noise / MusicSanitation / TrashSewer Back-upStray AnimalsTrees / Shrubbery Issues

26. Location of Problem*

28. Comments

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

* indicates a required field