Compliments and Concerns

2. Town of Platteville
   400 Grand Avenue Platteville, CO 80651 970-785-2245 970-785-2476 Fax

   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.

   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

24. Department

26. Resolution

28. Signature

29. Date of Signature
    Date of Signature

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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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