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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:


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

    This field is not part of the form submission.

28. Submit

* indicates a required field