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2. If a city plow has struck and damaged a resident's mailbox, please fill out the Report a Mailbox form. If you have further questions, please call Public Works at 651-454-4059.

4. Name*
5. Phone*
6. Date Damage Occurred to Mailbox*
   Date Damage Occurred to Mailbox
8. Address*
10. City
11. State
12. Zip Code
Leave This Blank:


14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

* indicates a required field