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2. **Use this form to report sidewalk structural defects/hazards only**

   Use this form to report sidewalk structural hazards, such as sidewalk heaving, broken sidewalks, or other sidewalk defects. Do not use this form to report items blocking the sidewalk, like overgrown bushes, cars, mattresses, or other debris. Those must be reported to CPDI staff at 406-552-6630.

4. CONTACT INFORMATION
6. First Name*
7. Last Name*
9. Phone Number*
11. Email Address
13. COMPLAINT LOCATION

    Please provide a specific address for the sidewalk hazard so that our inspectors can respond promptly.

15. Hazardous Sidewalk Address*
17. Describe the sidewalk hazard and specific location with as much detail as possible.
19. Attach Photo (optional)
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field