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2. Name*
4. Account Number*
6. Address*
8. City/County*
10. Phone Number*
12. Email Address (if available)
14. Reason for Request*

    1. Customer Light Out/Not Working
    2. Street Light Out/Not Working
16. Any other comments that will help Danville Utilities resolve the issue?
18. For any issue that is not customer light/street light related, please call 434-799-5255 for service.
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