Street light pole number: (Pole number is located 6-10 feet up from bottom of the pole; best method to identify pole needing repair.)
* Closest street address near the pole: example: 9999 W. Idaho St.
* Closest cross streets near the pole: example: Capitol And Idaho
In case we need to follow up with you, please fill in the following information.
* Your Name (Last, First MI):
Your daytime phone number: