HomeMy WebLinkAboutADA Sidewalks and Other Access Improvements (Fillable) Request for Repair of Sidewalk or Other Access Improvement
to Public Right of Way
Date:
Name:
Address:
Telephone: Cell:
Email Address:
Street address of the problem location (please be as specific as possible):
Please put an "x" in all boxes that identify the problem:
F-1 sidewalk broken
F-1 sidewalk unusable due to
debris ❑ tree roots ❑ shrubbery or other plant growth
gravel ❑ trash ❑ rocks
F-1 other: (please describe)
F-1 sidewalk impassable due to overhanging branches
❑ curb ramp problem due to
❑ too steep ❑ broken yellow mat ❑ yellow mat missing
❑ other (please describe below)
Date of this problem:
Please describe the impact of this problem on you:
This information will be forwarded to the Department of Public Works for
investigation and resolution. You will be contacted for more information, if
necessary, or to advise you of the resolution of this problem.
Please submit form via e-mail to dpweng@hawaiicounty.gov
Mahalo for bringing this problem to our attention!