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2. 
4. The City of Roswell FixIT Form will help us identify a problem in your area -- and work to fix it. Should a problem require urgent attention, please call us immediately. For a police emergency, dial 911. Otherwise, call (575) 637-6200.
   Thank you for your assistance!
6. Contact Information
8. First Name*
9. Last Name*
11. Address1*
13. Address2
15. City*
16. State*
17. Zip*
19. Phone Number*
20. Email Address*
22. Please indicate the nature of your problem by checking the appropriate box(es) below:
24. *

    1. Pothole
    2. Damaged curb
    3. Parks
    4. Traffic signals
    5. Weeds
    6. Dogs barking
    7. Loose dog(s)
    8. Abandoned vehicles
    9. Fire hazard

    1. Chemical discharge
    2. Water leaking
    3. Water Billing
    4. Litter
    5. Road striping
    6. ADA Complaint
    7. Street Lights
    8. Damaged sidewalk
    9. Traffic/Road signs

    1. Overhanging trees/shrubs
    2. Unsafe traffic conditions
    3. Noise nuisance
    4. Hazardous parking
    5. Storm sewer leaking/blockage
    6. Water leaking on roadway
    7. Loose/protruding manhole cover
    8. Sanitation issues
    9. Other
26. Brief Description (or other problem not listed)
28. Location of Problem
30. Attach a file to submit with form
32. Attach a file to submit with form
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field