The City of Peñitas, TexasCitizen Request for Services Form

Citizen Request for Services Form

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Use this form to request or report the following: repair of street or potholes, reporting of hazardous sidewalk condition, street or gutter drainage problems, bike paths and catch basin stoppages, street sign issues, traffic signal outage, streetlight outage (provide streetlight pole number). Your name, telephone number, and e-mail address are required should questions arise.

Reported location must be within the City of Peñitas Boundaries. The exact reported location/site address is required

Please use one form per request!

*First Name

*Last Name

*Phone Number

Email Address

*Street Address

Exact Location of Job Requested

*Street Name, Address or Block Number

Nearest Two Cross Streets

*Nature of Request