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2. Adopt a Road Form
   Use this form is you would like to Adopt a Road in Lumpkin County to pick up trash.
4. Name
5. Email Address
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Cell Number
16. Road you wish to adopt
    Please list the road or portion thereof you wish to adopt
18. Name or Organization
19. Number of People
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit Submit and Print

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