Work Request Form » Shire of Denmark

Is the Request Urgent?

YesNo

Request Origin

Ratepayer / Resident
Councillor
Council Officer
Local Business
Other Authority

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

Potholes
Kerb & Gutter
Spills/Foreign Matter
Road Markings
Grading
Gravel Required
Maintenance
Patch/Re-seal

Footpaths

Slip/Trip
Broken
Uneven
Reinstate
Verge

Drains

Blocked
Broken Pits/Lids
Flooded
Maintenance
Upgrade Required
Required
Kerb & Gutter

Signs

Damaged
Illegible
Found
Maintenance
Missing
Relocate
Incorrect
Required

Parks, Gardens & Reserves

Vandalism
Mowing
Slashing
Spraying
Reticulation
Amenities
Playground
Maintenance
Landscaping

Parking

Linemarking
Required
Signage
Issues

Trees & Vegetation

Prune
Remove
Dangerous
Tree Roots
Ants/Bee/Termites

Fire Control

Firebreaks
Vacant Blocks
Verge
Query

Council Buildings

Cleanliness
Damage
Vandalism / Graffiti
Maintenanced
Lighting not working
Lack of Lighting
Amenities
Plumbing
Safety Issues

Cemetery

Maintenance
Pruning
Mowing
Sunken Grave

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

YesNo