Street Light Problem Reporting

Please provide the information below to report street light problems or outages.  Please provide the pole number if possible:

Contact Information:

First Name
Last Name
Street Address
City
State
ZipCode
Home Phone
E-mail

What type of problem are you reporting?

Single Light Out
Multiple Lights Out
Light Cycling on and off
Light Flickering
Light on during day hours
Broken Glass
Open, broken, or missing light fixture
Damaged Pole
Exposed Wires
Lights blocked by trees
Other

Describe the problem you are reporting in more detail:

Outage Information:

Pole #
Nearest Street Address
Cross Street

The problem light is located to the: 

If light is not repaired within two (2) weeks, please resubmit:

Previously Submitted     Date of Original Submission:

Millcreek Township
Revised: August 08, 2007