Traffic Count Request Form
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Public Works Department
Traffic Division
11 English Street
Petaluma, CA 94952
707-778-4303
TRAFFIC COUNT REQUEST
Date:
Name:
Address:
City:
Zip:
Telephone:
Email:
This request for is for the daily average traffic count at:
Address:
Nearest cross street(s):
Street segment:
Other description/comments:
By signing below, it is agreed that the traffic count information given by this Department will
not be used in litigation against the City of Petaluma. After completing the form, please email
to
amirza@ci.petaluma.ca.us
by pressing Submit by Email in top left hand corner or send
hard copy to City of Petaluma, Traffic Division, 11English Street, Petaluma, CA 94952.
Do you wish to receive results by:
Mail
Email
Signature
Date
Reserved for staff response:
S:\City Engineering\Traffic Engineering and Operations\Traffic Counts\FORMS on Website\Traffic Count Form.doc
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