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Work Request Form
Firstname
Surname
Please enter a contact phone number which you can be best contacted on during office hours (no spaces required)
Location of where work is to take place
*
Please make note of a landmark if in the rural areas
Please select what type of work that best describes your request
Grading
Potholes
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Please give a detailed description of what work is required
*
Is this work of an urgent nature? eg: Is it dangerous to the public
*
In case of an emergency contact Council on 8558 0200 immediately
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No
Please provide any additional information
Do you require a response? (if yes please provide an email or postal address below, leave lines blank if not required)
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