MAINTENANCE REQUEST FORM

dpwlogoforform.gif (5347 bytes)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: