MAINTENANCE REQUEST FORM

MAINTENANCE REQUEST FORM
This Maintenance Request Form for citizens to report street and highway related problems for repair or to submit reports such as illegal dumping. If you live, work or are visiting our County and spot a problem, such as potholes, blocked storm drains, or missing or damaged traffic signs, please fill out the following form. If you notice problems concerning water mains or the sewer system, please call the Metropolitan Commission at (301) 373-4733.

If you do not see text editing areas below, your browser does not support forms. Instead send mail directly to: george_erichsen@stmarysmd.com

Please enter the date and time that the problem was noticed in the space below.
Date:
Time:

Please enter the location where the problem was noticed in the space below.
Address/Location: (required)
Street Name:
Intersecting Street:
Town or Election District:

Please select the problem you are reporting from the list below by clicking on the circle next to it
	ADA Curb Cut Out Ramps	Animal Carcass	Asphalt Road Damaged	Cracked or Broken Sidewalk

	Curb or Gutter Damaged	Debris in Gutter	Faded Striping	Final Inspection

	Graffiti Removal	Grate Frame Broken or Missing	Guardrail Damaged	Illegal Dumping

	Loose Stones	Missing Traffic Sign	Object in Drain	Object in Roadway

	Painted Curb	Pedestrian/ Handicap Ramp Damaged	Plugged Storm Drain or Ditch	Ponding in Yard

	Pothole	Storm Drain Overflowing	Street Flooded	Tree Trimming

Please enter any further details you may have on the problem that will help us to identify where the problem is located, why it is occurring and what exactly the problem is.


To help clarify questions about this service request, please provide the following information to be used only for this purpose:
Your Name: (required)
Your Telephone Number: (required)
Your E-Mail: