Work Request Form » Shire of Denmark

Is the Request Urgent? *

YesNo

Your Name *

Address

Email *

Phone Number *

Subject location (please be specific)

Location of Issue

Find by Street Address:

Details of Request (please be clear and specific)

Road

PotholesKerb & GutterSpills/Foreign Matter
Road MarkingsGradingGravel Required
MaintenancePatch/Re-seal

Footpaths

Slip/TripBrokenUneven
ReinstateVerge

Drains

BlockedBroken Pits/LidsFlooded
MaintenanceUpgrade RequiredRequired
Kerb & Gutter

Signs

DamagedIllegibleFound
MaintenanceMissingRelocate
IncorrectRequired

Parks, Gardens & Reserves

VandalismMowingSlashing
SprayingReticulationAmenities
PlaygroundMaintenanceLandscaping

Parking

LinemarkingRequiredSignage
Issues

Trees & Vegetation

PruneRemoveDangerous
Tree RootsAnts/Bee/Termites

Fire Control

FirebreaksVacant BlocksVerge
Query

Council Buildings

CleanlinessDamageVandalism / Graffiti
MaintenancedLighting not workingLack of Lighting
AmenitiesPlumbingSafety Issues

Cemetery

MaintenancePruningMowing
Sunken Grave

Would you like a Council Officer to contact you in relation to this request?

YesNo