Pothole Report

2. 

3. City of Inverness

   Pothole Report

5. Please note, this form is only for roads within the City of Inverness municipal limits and not intended for use for roadways outside of the City.

7. Today's Date*
   Today's Date
9. First Name
10. Last Name
12. Phone Number
13. E-mail

    If we may contact you by email, please provide.

15. Location*

    Location that the concerned was observed at.

17. Description of Observation*

    Please describe what was observed at the location of concern.

19. Is the pothole on an unpaved or dirt road?*

    1. Yes
    2. No
    3. Unsure
23. Picture Upload

    If you have a picture of the condition, please attached it here.

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field