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2. 

3. Work Order Request Form

   Need to report a town maintenance issue? Use this Work Order Request Form to request assistance with street or sidewalk repairs, fallen tree limbs, debris at public beach accesses, or other Public Works concerns. After submitting the form, a member of our Public Works team will contact you during regular business hours.

   For water or sewer issues, please contact CFPUA at (910) 332-6550, the emergency line at (910) 332-6565, or visit CFPUA.org.

5. Name
6. Email Address
8. Street Address of Work Location (address number and street name)*
10. City
11. State
12. Zip Code
14. Phone Number
15. Fax Number
17. Type of Service / Work Order Request
    -- Select One --Yard TrashAppliancesFurnitureJunkDamaged CartPublic Trash Can IssueBlocked StormdrainStreet RepairSign DamageSidewalk RepairOther RequestTown Employee Request

    Select the type of work needed.

19. Additional Information / Concern

    Describe additional details about the selected work request. If you selected "Other Request," describe that request here.

Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field