City of Medina




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Utility Locate Request

 

The City of Medina Ohio
Utility Locate Request
*First Name:
*Last Name:
Company:
*Phone:
*Today's Date:
*Date locate is needed by:
*Service Address of locate:
*Please check area of property for locate:

*Purpose of Digging:
*Locate Request by::
*OUPS Reference #:

This form must be completed and submitted to the City of Medina Service Office prior to digging.  A seperate submittal is necessary for each requested location.

*Note the request for locates must be submitted and received 48 hours (work days) in advance of the work to be done.

You may also print this form and fax it to the City of Medina, Service Office, fax number (330) 722-9045.

(OUPS #1-800-362-2764)  *A OUPS Reference number is required.


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