Purpose. Use this form to make a request for a new sidewalk at a location where one does not exist.

First Name:*

Last Name:*

Email:*

Daytime Phone:*

Street:

City:

State:

ZIP

On what street would you like the sidewalk to be placed:*

State where you would like the sidewalk to begin (street name, address, etc.)*

State where you would like the sidewalk to end (street name, address, etc.)*

What side of the street would you like the sidewalk placed

North South East

West Not sure (please describe below)

If you answered "not sure" above, please provide details here.