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Citizen Request for Services Form

  1. Use this form to request or report the following non- emergency issues: repair of street or potholes, reporting of hazardous sidewalk condition, catch basin stoppages, street sign issues, traffic signal outage, streetlight outage (provide streetlight pole number). Your name, telephone number, and e-mail address are not required, but are helpful should questions arise.
  2. This form will help us identify a problem in your area -- and fix it fast. Should a problem require urgent attention, please call us immediately. For a police emergency, dial 911. For police non-emergencies, animal control issues or after hours sewer/ drainage problems, call 973-680-4141. Otherwise, call (973) 680-4077 between the hours of 8:30-4:30pm. Thank you for your assistance!
  3. Contact Information
  4. Reported location must be within the Township of Bloomfield Boundaries. The exact reported location/site address is required
  5. Please indicate the nature of your problem by checking the appropriate box(es) below:
  6. Damage Sidewalk REPORT NOTICE

    Maintenance and repair of sidewalks and curbs is the homeowner’s responsibility.  

    § 497-16. Permit required for construction; duration.

    A. The installation, repair or replacement of curbs and sidewalks is the responsibility of the abutting property owner.

    [Added 11-2-1987]

  7. Leave This Blank:

  8. This field is not part of the form submission.