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2. 
4. City of Cohoes
   97 Mohawk Street, Cohoes, N.Y. 12047 www.cohoes.com
6. Use this form to submit a request or report an issue to the Department of Public Works. You can also call DPW at 518-233-2139.
8. CITIZEN REQUEST FORM / REPORT AN ISSUE
10. First Name*
11. Last Name*
13. Phone Number*
15. Email Address*
17. REPORT AN ISSUE*
    -- Select One --Citizen -Broken GlassCitizen- Brown WaterCitizen- Garbage/Trash Removal/ RecyclingCitizen-Leaf BagsCitizen- OtherCitizen- Pothole/RoadworkCitizen- Roadkill/Animal RemovalCitizen- Sewer/Catch BasinsCitizen- Street LightsCitizen- Street SignsCitizen- Street SweepingCitizen- Traffic SignalsCitizen- Weeds/High GrassCitizen- Fire Hydrant/Broken/Leaking

    Please select an item from the drop box to report the issue.
18. Street Location*
    Please include nearest cross streets or a building number.
19. Upload An Image
21. Additional Comments
23. Disclaimer
    This form does not constitute written notice of a defective, unsafe, dangerous or obstructed condition of any street, highway, bridge, culvert, sidewalk or crosswalk pursuant to Cohoes City Code Section 41-5 or any federal, state of local law, rule, or regulation.
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25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

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