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Traffic Request Form

2. Contact Information
4. Name*
5. Date*
7. Street Address*
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Work / Mobile Phone
16. Email Address*
18. Traffic Control Device Information
20. New Traffic Control Device(s) Requested*

    1. Crossing Guard
    2. Marked Crosswalk
    3. Multi-Way Stop Sign
    4. Parking Restriction
    5. Sight Distance Analysis
    6. Street Light
    7. Stop Sign
    8. Striping Modification
    9. Traffic Signal
    10. Other
22. If other, please specify
25. Location(s) and Reason(s) for Request*
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

* indicates a required field