CITY OF LAKE WALES
REPORT A STREETLIGHT OUT

Use this form to report a non-functioning streetlight in Lake Wales.

Identify the location of the streetlight by: (a) providing names of nearest cross streets; or, (b) indicating location in relation to intersecting streets.

Subject:
Today's Date:
Name:
E-mail:
Location of Streetlight (street name):
(a) nearest cross streets:
(b) at the intersection of:

NOTICE: Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not provide your e-mail address for reply purposes.


Additional Descriptive Information:



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