Forms • Pothole

Pothole

Leave This Blank:

Use this form to report a pothole.

Address*

Address 2

Chelmsford, MA

Zip Code:*

Approximate Location*

Size of Pothole:*

	Small (Less then 12 inches across)
	Medium (12-24 Inches)

Large (Over 24 Inches)

Special Circumstances:

is creating a traffic hazard

is on a major street

* indicates required fields.