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Report a pothole

Pothole location

Please provide the street name and the nearest intersecting street name of where the pothole is located or use the map below to pinpoint its location.

Street name

Nearest intersecting street name

Pin point location using the map

Additional comments

Verification

Name

Phone

Date

Signature I acknowledge that [by displaying/typing my name above], I am signing this application, and I agree to be bound as if I had endorsed this document with my own handwritten signature.

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Protection of Privacy Act (POPA)

The personal information on this form is collected under the authority of Section 4(c) of the Protection of Privacy Act (“the Act”) and will be used solely for the creation and support relating to the submitted service request.

It will be treated in accordance with the Collection of Personal Information provisions (Part 1, Division 1) of the Act. Questions concerning collection of this information can be directed to the City of Airdrie at 400 Main Street SE, Airdrie, AB T4B 3C3 or 403.948.8800.