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Traffic Signal Evaluation Request Form
Traffic Signal Evaluation Request Form
Streets must be within Charlotte City Limits.
Please complete the following information:
*Indicates required fields for submitting request.
Date*
Name*
Address*
City*
State*
Zip*
Email Address*
Daytime Phone*
Evening Phone
Please provide us with the following information about the intersection to be evaluated:
Intersection Address*
What type of evaluation is being requested?*
New Signal
New Left-Turn Signal
Timing Issue
What time of day are you experiencing the problem?*
Please select...
5:00 a.m. - 7:00 a.m.
7:00 a.m. - 9:00 a.m.
9:00 a.m. - 11:00 a.m.
11:00 a.m. - 1:00 p.m.
1:00 p.m. - 3:00 p.m.
3:00 p.m. - 5:00 p.m.
5:00 p.m. - 7:00 p.m.
7:00 p.m. - 9:00 p.m.
9:00 p.m. - 11:00 p.m.
11:00 p.m. - 5:00 a.m.
When did the problem start?*
If your request is for a left-turn arrow or additional green time, please indicate the traffic direction and time of day of worst condition (example: Left-turn from Westbound Independence to Southbound Sardis at 7:30 a.m.).*
Please provide additional comments on the condition (Example: I have to wait 15 minutes to get through the light.).
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