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2. First Name*
4. Last Name*
6. Address*
8. City *
9. State*
10. Zip Code *
12. Phone*
13. Email *
15. Residency*

    1. Full Time City Resident
    2. Seasonal City Resident
    3. Property Owner in City
    4. Business Owner in City
    5. City Utility Customer inside corporate limits
    6. City Utility Customer outside corporate limits
17. Comments*
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