Streetlight Repair Request

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Please correct the field(s) marked in red below:

1

Where is the malfunctioning streetlight located?

2

Please describe how the streetlight is malfunctioning.  Check all that apply.

3

How long has the streetlight been malfunctioning?

By submitting this form, I CERTIFY that all statements and information furnished on this form are true, complete and correct to the best of my knowledge and belief, and are made in good faith. 

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