2. The Town of Dewey-Humboldt Fix It Form will help us identify a problem in your area - and fix it fast. Should a problem require urgent attention, please call us immediately at 928-632-7362. For other forms, go to Home, Government, Printable Forms.
   
   Thank you for your assistance!
4. Contact Information
6. First Name*
7. Last Name*
9. Address*
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Email Address*
18. Please indicate the nature of your problem by checking the appropriate box(es) below:
20. 1. ADA complaint
    2. Blocked drainage channel
    3. Damaged sidewalk
    4. Dogs barking

    1. Fair housing complaint
    2. Noise nuisance
    3. Pothole
    4. Road striping

    1. Storm sewer leaking / blockage
    2. Traffic signals
    3. Traffic / road signs
22. Brief Description (or other problem not listed)
24. Location of Problem
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

* indicates a required field