County Road Problem Report

2. County Road Problem Report
   Use this form to report problems with County roads, including danger trees in the right of way, trees down in the right of way, deceased animals in the right of way, debris in the right of way and drainage issues in the right of way. DO NOT USE THIS FORM TO REPORT EMERGENCIES THREATENING LIFE OR PROPERTY OR THAT REQUIRE IMMEDIATE RESPONSE TO PREVENT FURTHER HARM TO LIFE OR PROPERTY. Call 911 for all emergencies, including accidents, power lines in the roadway and road closures that prevent emergency entrance and egress to occupied areas.
4. Confirm that you are reporting this to the correct agency*

   Please confirm that the road associated with your report is (1) Located in Jefferson County, Washington; (2) Located outside the boundaries of the City of Port Townsend; (3) Not a state highway, such as Hwy 101, Hwy 20, Hwy 19, Hwy 104 or Hwy 116; and (4) A county road with a green street sign, not a private road with a brown or red street sign. You can also use this form to report issues with trails maintained by Jefferson County Public Works, such as the Larry Scott Trail.

   1. Yes, I am reporting a problem with a Jefferson County, WA, road.
   2. Yes, I am reporting a problem with a trail that Jefferson County, WA, Public Works maintains
6. Type of problem*

   1. Debris in right of way
   2. Tree down in right of way
   3. Tree threatening right of way
   4. Deceased animal in right of way (deer or larger)
   5. Drainage issue in right of way
   6. Pot hole or other surface damage
   7. Damaged/missing road sign
   8. Damaged guardrail or ditch
   9. Landslide
   10. Other
7. The reported problem is...*

   1. Fully blocking the road or trail
   2. Blocking one lane
   3. Intruding into one lane
   4. On the shoulder or in the ditch only
9. Please describe the problem you are reporting*
11. Upload a photo or sketch of the problem (optional)
13. Where is this problem located? Provide a full address if known or a thorough description so our crews can locate it.*
17. Your contact information
    It is completely optional to provide one or more methods of contacting you. However, if you provide this information, we can contact you if further clarification is required, and we can contact you with a resolution to your reported problem.
19. Name
20. Email Address
22. Address
24. City
25. State
    -- Select One --Washington
26. Zip Code
28. Phone Number
29. Do you want to be contacted?

    1. Yes, please let me know about the resolution to the problem.
    2. No, I do not need a response about the problem.
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field