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2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Type of Request

    1. Curb
    2. Sidewalk
14. Location of Request
    Please be as specific as possible; use street address where possible. (For example: 301 to 456 Main Street, SW, or Juniper Avenue between Aspen Street and Spruce Street)
16. Justification
    Please explain why you are requesting curb and/or sidewalk.
18. Safety
    Will new curb and/or sidewalk address a safety hazard? How?
20. Drainage
    Is your request to solve a drainage problem? If yes, describe the problem and any damages that are recurring as a result of drainage problems.
22. Citizen / Neighborhood Support
    Is anyone else on your street interested in curb and/or sidewalk? Please attach a list of names and addresses of those who would be affected. How many are in support of the project? Does anyone object?
23. Upload Petition or List of Supporters
25. Additional Comments
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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