Incident Report
Home

 

LAKE PONDEROSA PATROL FORM

Please use this form to report incidents on the lake/road that you feel should be brought to our attention. 
You may submit your incident report by completing the form on-line below, or print a copy and mail it to Ponderosa Utilities.

To Print and Mail Report: (click here) Print copies uses Adobe Reader. If you do not have Adobe, you may download your copy of Adobe here. Go to Adobe


Today's Date:
Your Name: 
Address:
Telephone Number:
Date of Incident:
ID#:
Lot Owner’s Name (if known):
Location:

Infraction: (Please describe the incident below in as much detail as possible)


PLEASE NOTE: Forms will not be acknowledged unless completely filled out.

Forms received in our office will be acknowledged within 5 (five) business days after receipt.  Thank you for your cooperation in helping keep Lake Ponderosa a safe and enjoyable place to live.

Mail to:

Ponderosa Utilities, Inc.
386 Center Point Dr – Lake Ponderosa
Montezuma , IA 50171