2. Town of Platteville
   400 Grand Avenue Platteville, CO 80651 970-785-2245 970-785-2476 Fax
4. Compliments and Concerns
   The following personal information is not required but is recommended for follow up contact on the situation being addressed below.
6. First Name*
7. Last Name*
9. Address1*
11. City
12. State
13. Zip
15. Phone Number
16. Your email address*
    To receive a quick response, please include your email address.
18. Description of Situation Being Addressed
22. Official Use Only
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field