E-Gov Services Midland

Request for New Sidewalk

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

* Information is required.

Contact Information

* First Name:
* Last Name:
* Email:
* Daytime Phone:	() –
Address:
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 sidwalk 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.

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

When you submit information through this form, you will receive a Tracking Number. You can track the status of your request by entering your tracking number in the field provided on the "Services and Information Requests" page.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.