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Welcome to the Moon Township, PA, Citizen Request System
Today is Thursday, March 30, 2017.
Pothole

Purpose. Use this form to report a pothole.

* Information is required.

Contact Information

First Name:
Last Name:
Business Name:
Email:
Daytime Phone: (
Fax: (
Address:
City:
State:
ZIP:

* Location of pothole (be as specific as possible).
 
* Size of pothole
Small (less than 12 inches across)
Medium (12-24 inches)
Large (over 24 inches)
 
Special Circumstances
Is creating traffic hazard
On major street
3
 
Check here to have email confirmation of this submission.

* Information is required.

Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.

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