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Name: _____________________________________________Phone: _____________

Address: ___________________________________________Zip: ________________

Your Neighborhood:__________________________________Email: ______________

  • In general, what are your concerns about the traffic in your area? (please all that apply)

__Speeding __Cut-through traffic __Frequent crashes
__Exhibition Driving (such as "donuts") __Other (please explain) ________________________________________________________________

  • Are there specific streets that you would like to make safer? If so, please list them. ________________________________________________________________
  • What concerns you about these locations?

_______________________________________________________________

Check if they involve a local school? __School Name:___________________

  • Do you have suggestions on how to improve your area?

_______________________________________________________________

Important! To be considered for traffic calming, you must have signatures below, and an attached map of the problem area.

Signatures. Please have at least ten people from your neighborhood sign this portion of the form before you submit it.

Printed Name Signature Address Phone # Email

1____________________________________________________________________

2____________________________________________________________________

3____________________________________________________________________

4____________________________________________________________________

5____________________________________________________________________

6____________________________________________________________________

7____________________________________________________________________

8____________________________________________________________________

9____________________________________________________________________

10___________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Please return to:

Municipal Transportation Agency
Planning Division
Traffic Calming Program
1 South Van Ness Avenue - 7th Floor
San Francisco, CA 94103

   
   

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