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CCMCD

Request for Service

Please fill out the Request for Service form below.

*REQUIRED
*Name:
  First Last
*Address:
  House # & Street Name City
Cross Street:
  To help verify location. Zip Code
Subdivision:
 
Phone:
  *Home Cell
Available:
 
  *Details of Request:
 
 
Time of Day: Dawn Morning Afternoon Dusk Night

  Permission to inspect property for mosquitoes?
  Permission to treat property for mosquitoes?
 
  Any concerns or safety hazards the inspector should know about?
Examples: dogs, locked gate, soft ground, flooded road, known snakes in area, etc...
 
  Disclaimer: The following requests for service is provided for your convenience. CCMCD will attempt to address your issues in a timely manner upon receipt. However, CCMCD cannot guarantee an immediate response to you issues through this procedure. If you feel that your complaint is of an urgent nature and/or may constitute a threat to health, safety and welfare, you should contact Mosquito Control directly at (352) 527-7478.
 
  To submit this form, please enter the characters you see in the image:
  Image verification (lowercase)
 
 


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