Location {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Number of streetlights requested {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Description of the area the streetlights are needed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Number of total signatures {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Upload Signatures {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
I hereby respectfully petition the James City County Board of Supervisors to provide streetlights in our area. I understand that the information provided in this petition may be shared with the utility company serving the area to aid in the planning and design of the requested streetlights. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Electronic Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Office Use Only
Returned to General Services {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Reviewed by Capital Projects {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Reviewed by Community Development {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }