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STREET LIGHT MAINTENANCE REQUEST
STREET LIGHT MAINTENANCE REQUEST
Please give an accurate description of the location of the streetlight. The street name, the closest
intersection and pole number would be very helpful, if they are possible to obtain. The pole number is located at eye level on the street side of the pole.
Date Reported
Reported By
Address
Phone Number
Pole Location Description
Pole Number
Problem
Select
Light off
Light on
Light on/off
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