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2. What is the condition of the sign?*
   -- Select One --Sign is missing.Sign is still there, but damaged.Sign is still there, and not damaged.Sign has been dropped off at the landfill office.
4. What is the condition of the pole?*
   -- Select One --Pole is missing.Pole is still there, but it's damaged.Pole is still there, and not damagedPole has been dropped off at the landfill office.
6. Please name the intersection where the sign is damaged or missing.*
8. Is this a single sign or an intersection sign that shows both road names?*
   -- Select One --Single sign.Intersection sign with both road names shown.I don't know.
10. When did you first notice that the sign was missing or damaged?
    When did you first notice that the sign was missing or damaged?

    When did you first notice that the sign was missing or damaged?
12. How can we contact you if we need to find out more information?
14. First Name
15. Last Name
17. Email Address*
18. Confirm Email*
20. Phone Number
22. Feel free to add any additional information you think would be helpful to us.
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

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