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2. Contact*
   -- Select One --License Commission, Law Department, John Peyers
4. This contact form is used to communicate with a member of the City of Lowell, and will be routed internally as appropriate.
6. Please DO NOT use this form to request a specific service or report a code violation
   Request Tracker

   To request a specific service, or report a code violation, please use the link above
8. While you may choose to remain anonymous, by leaving your contact information blank, filling it out will better assist us in communicating with you as appropriate.
10. Contact Information
12. First Name
14. Last Name
16. Business Name
18. Email
20. Phone Number
22. Fax Number
24. Address
25. City
27. State
28. Zip Code
30. Location Referenced in Your Comments (If Applicable)
32. Please DO NOT use this form to request a specific service or report a code violation.
    To request a specific service, or to report a code violation, please use this link.
34. If you are reporting a non-specific area of the City, please indicate so in the 'Location Details' field below.
36. Address
37. City
39. State
40. Zip Code
41. Unit
43. Location Details
45. Comments*
47. Notes
49. Please be aware that any communication(s) made through this system by you or your agent(s), servant(s), or any other representative(s), whether authorized or unauthorized to the City of Lowell, Massachusetts, the Commonwealth of Massachusetts, the owner and/or operator of this web site, and/or any other web site operated by or pursuant to license or agreement by the City of Lowell, Massachusetts, its agencies, officers, employees, agents or representatives shall in no event be deemed to constitute notice for any purpose, whether legal, official, or other.
51. The submission of this form and/or assignment of a Tracking Number, indicates your acceptance of these terms and the City of Lowell's Terms of Use, and may subject your submission to disclosure.
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