2. Town of Platteville
   400 Grand Avenue Platteville, CO 80651 970-785-2245 970-785-2476 Fax
4. Compliments and Concerns
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6. First Name*
7. Last Name*
9. Address1*
11. City
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18. Description of Situation Being Addressed
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24. Department
26. Resolution
28. Signature
29. Date of Signature
    Date of Signature
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