Lewis County, New York- Maintenance Request Form

Maintenance Request Form

COURT HOUSE MAINTENANCE 315-376-5321 or 315-376-5700

CELL 315-489-2552 Matt

CELL 315-586-2001 Shawn

CELL 315-681-0656 Joe

PSB MAINTENANCE 315-376-5378

DSS Office Phone 315-376-5440 Leave Message

Department

Description of Work Requested

Requested By

Priority

Contact Person

First Name

Last Name

Phone Extension

Your Email

Date of Request

FOR BUILDING AND GROUNDS SUPERVISOR ONLY

Approval:

Date Started:

Date Finished:

Employee Name:

Confirm

Cancel