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Neighborhood Action Request Form

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We, the undersigned, request a neighborhood meeting to discuss application of traffic calming measures in accordance with the County's Neighborhood Traffic Management Program. The following signatures representing at least seven different residents in the neighborhood, which indicates the neighborhood's commitment to work with the DPW for a safer traffic environment.

 

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Contact Name _____________________________________ Day Phone: ____________________

Address: ___________________________________________ Today's Date: _________________

Location of Concern:_______________________________________________________________

What concerns do you have at this location?
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