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2. Request to ADD a streetlight
   To be completed by the city
4. Your request to ADD a streetlight on:
5. located on National Grid Co. Pole No:
7. has been evaluated according to the City of Northampton's established criteria. A copy of the field evaluation form for this location is attached.
9. Field Evaluation:
11. Request is:*

    1. Approved
    2. Denied
12. For approved requests, the recommended lighting to be installed is:
14. - If the request is approved, and assuming that funding is available in the current fiscal year, Central Services will place a service request for the approved task.
16. - If the request is denied, such denial may be appealed to the Mayor.
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit Submit and Print

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