STREET LIGHT OUT REPORTING FORM
Problem Reporting
Light is out
Light is on and off
Light is on during the day
Light is dim
Globe on light is broken
Globe on light is open
Pole is broken or damaged
Pole is leaning
*
Name
*
Phone Number
*
Email Address
*
Where is the light located?
(Please indicate the nearest house number.)
*
What is the nearest cross street?
*
Light Location
Corner
Mid-Block
Parking Lot
Alley
What is the number on the pole?
Describe the details of the problem you are reporting
1001 Belgrade Avenue | P. O. Box 2055 | North Mankato, MN 56002-2055
Tel 507-625-4141 | Fax 507-625-4151 |
Email
STREET LIGHT OUT REPORTING FORM 