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Pothole / Road Hazard / Mowing / Missing Road Sign Form

2. Report a Pothole or Road Hazard
4. Complete and submit this form to report a pothole, non-emergency road hazard, roadways that needs mowing/trimming attention, or a missing road sign for County Roads ONLY (NOT for State Roads, Nashville Town Limits, or Cordry-Sweetwater District Limits). Thank you!
6. Complete This Section to Report a Road Hazard/Pot Hole
8. County Road Name*
10. Issue:*

    Please include road name of nearest crossroad/mile marker, type of hazard, any other details pertaining to the hazard, etc.

12. Submit Image of Road Hazard (if applicable)

    *only one (1) image is able to be uploaded

13. Date/Time when First Noticed (if applicable)
    Date/Time when First Noticed (if applicable)

    Date/Time when First Noticed (if applicable)
15. Enter Your Contact Information
17. First Name*
18. Last Name*
20. Address*
22. City*
23. State*
24. Zip Code*
26. Phone Number
27. Email Address
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field