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Pothole Complaint Form

2. Please complete the online form below to submit your complaint.
   Please do not report potholes on Route 17 or Route 287 as these are state/county roadways.

   Please do not report potholes on Route 17 or Route 287 as these are state/county roadways.

4. Contact Information

6. Name:

8. Address:

10. Telephone Number:

12. Email Address:

14. Location

16. Specify Location:*

18. Intersecting Street:

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19. 1. Receive an email copy of this form.
20. Email address

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21. Submit

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