Please allow our full-time maintenance staff at least 2 business days to complete your request.

**For gas leaks, please call Centerpoint Energy**

**For water leaks, please shut off the water to avoid larger-than-normal water bills**

Items marked with * are required.
* First Name:
* Last Name:
* E-mail:	username@domain.com
Phone Number:	xxx-xxx-xxxx
* Property Address:	Select An Address 1023 N. Riverfront Dr. 104 W. Pleasant. St. 110 Glenwood Ave. 110 Wheeler St. 111 Knollcrest Drive 1110 Warren Street 113 E. Welcome Ave. 114 S. 4th St. 115 State Street 117 E Cherry Street #1 117 E Cherry Street #2 118 S. 4th St. 119 E. Welcome Ave. 121 Hanover Street 1717 6th Avenue 1721 6th Avenue 1902 3rd Ave. 1935 4th Ave. 1939 4th Ave. 208 E. Lewis 215 Van Brunt St. 217 S. Broad St. 220 Cross St 221 Van Brunt St. 225 S. Broad St. Apt. 1 225 S. Broad St. Apt. 2 225 S. Broad St. Apt. 3 304 W. Pleasant St. 312 Center St. 313 E. Pleasant St. 317 Fulton Street 317 Fulton Street #3 318 E Washington Street 320 Warren Street 321 N. 6th St. Apt. A 321 N. 6th St. Apt. C 323 Center St. 324 E Liberty Street 324 E. Pleasant St. 325 E Cherry Street 325 Fulton Street 326 Warren St. 328 N. 6th St. 401 Lilly Street #1 401 Lilly Street #2 413 Lilly Street 414 Madison Avenue 417 Byron St. 419 Byron St. 420 N 2nd Street 420 State St. 429 N 6th Street 429 N. 6th St. 430 N 2nd Street 430 N 2nd Street #2 513 Record Street 526 S 5th Street 528 S. Front St. 528 S. Front St. 619 N 4th Street 724 N 2nd St. 808 N. 5th St. 813 N. 2nd St. 815 N. 2nd St. 830 S. Front St. 902 N 5th Street 904 N 5th Street 910 S Front Street 926 S Front Street 930 S. Front St. JGH
Apartment Number:
Type of Problem:	SELECT ONE Plumbing Electrical Doors Windows Noise Appliances Other
* Questions/Comments:
Is this the first time you've had the problem?	Yes No
If No, Date last time:	MM-DD-YYYY or MM/DD/YYYY
Permission to Enter:	No permission needed Contact first
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