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2. Your Name
4. Address
5. Apartment Number
7. City
8. State
9. Zip Code
11. Phone Number
12. Email Address
16. Police Department Questions/Concerns
    -- Select One --Animal ControlNoise ComplaintSpeeding ProblemsAbandoned Junk VehiclesOther Traffic Complaints

    Please choose the category that best describes your question or concern. 

18. Question or Concern
22. Public Works & Engineering Question/Concern
    -- Select One --Burned Out Street LightDrainage ProblemSewer StoppageStreet Sign ProblemsStreet RepairTraffic Light ProblemWater Leak

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24. Question or Concern
28. Utility Billing & Collections Question/Concern

    Please describe briefly your question or concern. 

32. Code Enforcement Question/Concern
    -- Select One --High WeedsJunk, Trash, etc.Abandoned HouseUnsafe BuildingFood Establishment ViolationsEnvironmental ViolationsOff-Premise SignsSmoking in Restaurants

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34. Question or Concern
38. Miscellaneous Question/Concern

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40. Privacy Statement
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