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2. Submit a Request

   This is a public document and subject to disclosure under the Public Records Act. If you wish your identity to remain confidential, this form may be filed anonymously. Please note, all service requests submitted through this form will be reviewed; however, those that include the requester’s name and contact information will be prioritized for follow-up.

   This form is for non-emergency requests only. If you need immediate assistance or are reporting an urgent issue, please call the appropriate department directly. Do not use this form to report emergencies.

4. What can we help you with?*
   -- Select One --Doing Business Without a LicenseBusiness LicenseCity Street TreesConstruction Without a PermitDebris, Junk, and/or RubbishFire Department EngagementGraffitiHousingIllegal DumpingLiability ClaimsNuisancesOvergrown Weeds (Private Property)Park MaintenancePermitsPotholes & Road MaintenancePublic Records RequestRecreation Programs and ClassesRentals: Facilities and ParksSubstandard ConditionsUnsecured Vacant BuildingVehiclesWater Leaks in Public Right of WayWater Quality/Water PressureStreet LightsZoning Violations
6. Type of Permit:
   -- Select One --ADU & JR ADU Information PackageArchitectural & Site Plan ReviewBuildingConditional Use PermitEncroachment & Trench CutFence PermitFire Hydrant UseFlood ElevationFront Yard Flat WorkGradingOversized Load & House MoverSign PermitSpecial EventSpecial Variances
8. Specify Vehicle Issue*
   -- Select One --Abandoned VehicleParking in Landscape
10. Type of Housing Application:*
    -- Select One --First Time HomebuyerMinor Home Repair
12. Type of business activity:*
    -- Select One --Contractor License (Contractors based outside the city who are conducting business within city limits.)General Business License (Businesses operating within city limits, as well as for professional or consulting services conducted from outside the city.)Home-Based Business License (Businesses operated from a residence within city limits. *Please note: this process begins with a review by the Planning Department to ensure compliance with zoning.Mobile Vendors License (Businesses that operate on a mobile basis, e.g. food trucks, mobile services.)
14. Where is the dumped material located?*
    -- Select One --Salado CreekStreet and/or SidewalkPrivate Property (residence, vacant property)
16. What facility or park do you wish to rent?*
    -- Select One --Aquatics CenterHammon Senior Center
18. Click "Submit" and we'll take you to the right form for your request.
20. I wish to remain anonymous*

    The City of Patterson does not disclose the identity of individuals who submit requests. If contact information is provided, it will remain confidential and will not be shared with the subject of the report.

    1. No
    2. Yes (I understand that by choosing to remain anonymous, my request may not be prioritized unless it involves a public safety concern. I also acknowledge that I will not receive any follow-up or updates regarding this request.)
22. First Name:*
23. Last Name:*
25. Email Address*
26. Phone Number:
28. Contact method:*
    -- Select One --EmailPhoneNeither
29. I would like to receive updates on my request:*
    -- Select One --YesNo
31. Company*
33. Project Name*
35. Location of Issue:*
37. Cross Street (if known):
39. Vehicle Make*
40. Vehicle Model*
41. Vehicle Color*
42. Vehicle License*
44. Pole Number*
45. How long has the problem been occurring?
47. Type of Pole*
    -- Select One --MetalWood
48. Type of Problem*

    1. Light is completely out
    2. Light is flickering
    3. Other, please explain below
50. Please describe your request:*
52. Other Comments:
54. Upload Photo:

56. *Indicates required fields

Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit

* indicates a required field