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2. If you would like staff to follow-up with you directly regarding your request, please provide your name and contact information below. This information will only be shared with Village personnel to the extent necessary to address your request. Pictures may be sent to info@lagrangepark.org (please reference this form).
4. Name (First & Last)
5. Email Address
7. Your Address
9. Phone Number
10. I prefer to be contacted*
    -- Select One --via email (please provide above)via phonedo not contact me
12. Please check all that apply:

    1. airplane noise
    2. backyard flooding
    3. block parties
    4. business license
    5. construction hours violation
    6. dog license
    7. fraud suspicion
    8. garbage & recycling
    9. outdoor storage & debris

    1. sidewalk concern
    2. signage
    3. street condition
    4. street light
    5. tall grass & weeds (>10")
    6. temporary storage containers / PODS
    7. traffic enforcement
    8. tree (parkway)

    1. tree (private)
    2. vacation watch
    3. vehicle stickers
    4. water billing
    5. water meter/water service
    6. zoning verification
    7. other code enforcement violation
    8. other (general)
14. Property location*
16. Provide additional details regarding your concern/request
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit Submit and Print

* indicates a required field