Pothole Repair Request Form

The Department of Public Works performs pothole repairs to local streets and roadways in the City of Perth Amboy. To report a pothole, you may either call (732) 826-2010 or complete the form below to report a pothole electronically.

Name:

Home Address:

City:

State:

Zip:

Email:

Email: :: Please enter a valid email address so that you can receive an email copy of your request.

Phone:

Location of Pothole:

Location: :: Please enter the road or street name. Other details to include if possible, Nearest Landmark, House or Business Number or Utility Pole Number

Nearest Cross Street:

Position of Pothole:

Area:

* Requests will be processed in the order that they are received. Processing of requests will take approximately seven to ten business days.

Additional Comments:(10 Line Limit)