2. Type of Issue*

   1. Cemetery Maintenance
   2. Solid Waste (includes cart repairs, dead animal collection, and missed waste collections)
   3. Streets & Grounds (includes bike lanes, greenways, parks, potholes, sidewalks, streets signs, and tree hazards)
   4. Stormwater (includes flooding, illicit discharge, and stormwater services)
4. Cemetery*

   1. Old Carrboro Cemetery
   2. Westwood Cemetery
   3. Weaver Family Cemetery
5. Cemetery Block/Plot Number (if known)
7. Deceased Name (First and Last)
9. Description of Issue *
11. Contact Name (First and Last)*
13. Do you wish to be contacted about this issue?*

    1. Yes
    2. No
14. If yes, preferred method of contact?*

    1. Telephone
    2. Email
16. Telephone Number
18. Email
20. Type of Solid Waste Issue*

    1. Cart repair
    2. Dead animal collection
    3. Missed waste collection
21. Type of Missed Waste Collection

    1. Bulk Waste
    2. Commercial/Multi-Unit Apartment
    3. Household Waste
    4. Yard Waste

    Please leave your container curbside and Public Works will be back to collect your waste.

    If you have submitted this form after 3 pm, your container will be collected on the following day.

23. Type of Missed Yard Waste

    1. Loose Leaves Piled at Curb
    2. Yard Waste (leaves and brush) Piled at Curb
    3. Yard Waste (leaves and brush) in Roll-out Cart
24. Type of Cart

    1. Household waste cart
    2. Yard waste cart
26. Description of cart repair needed*

    Please make sure your cart is visible and easily accessible.  Public Works will repair your cart within the next 48 hours.    

28. If your cart is deemed unrepairable and must be replaced; would you prefer to keep your old cart or have Public Works remove it?*

    1. Keep damaged cart
    2. Remove damaged cart
30. Type of Streets & Grounds Issue

    1. Bike Lane
    2. Bike Fix-it Station
    3. Debris in Travel Lane
    4. Drainage
    5. Greenway
    6. Park

    1. Pothole
    2. Sidewalk
    3. Snow/Ice
    4. Street Sign
    5. Tree
32. Description of Issue
34. Location - Address/Street Name*

    Please provide a valid address

36. Location Details

    Provide nearby intersection or GPS Coordinates if possible.  

38. Contact - First Name*
39. Last Name*
41. Do you wish to be contacted about this issue?*

    1. Yes
    2. No
42. Preferred method of contact:

    1. Telephone
    2. Email
44. Phone Number
45. Email Address
47. Upload Photo
49. Type of Stormwater Issue

    1. Report Flooding Issues
    2. Report Illicit Discharge
    3. Request Stormwater Services
    4. Request Stream Determination
50. Flooding Issues
    Report Flooding Issues

    Please use the above link to report flooding issues.

52. Illicit Discharge
    Report Illicit Discharge

    Please use the above link to report illicit discharge.

53. Request Stormwater Services
    Request Stormwater Services

    Please use the above link to report Stormwater services.

55. Request Stream Determination
    Request Stream Determination

    Please use the above link to request stream determination.

Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit Submit and Print

* indicates a required field