2. Your name
3. Your phone number
5. Address of issue
6. Closest intersection
8. Your Email Address
10. Select the Issue
    -- Select One --Report Damage to City Property/Public SidewalksReport PotholeReport GraffitiOther
12. Additional Information
14. Upload Image
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16. 1. Receive an email copy of this form.
17. Email address

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18. Submit

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