Traffic requests

This request form allows residents of Lac-Brome to submit a request to initiate a study of traffic calming measures in their area or to make any other request related to the mobility of people on the territory.

Purpose of the request

Please select the subject of the request•

Applicant contact details

First name•

Last name•

Address•

Postal code•

Phone number (home)•

Phone number (work)

Phone (cell)

Email•

Request Information

Location of the problem area (street/intersection)•

Sketch of the problem area (attach sketch or image, if applicable)

Drop files here or click to upload them.

Hour or time of day the event occurs (if applicable)

If applicable

Does the issue involve a school zone or a park?•

If yes, please specify

Do you have one or more suggestions to improve the safety of residents in your sector?

Request support

Your request must be completed by at least one resident 18 years of age or older. However, it is recommended that signatures of support be collected in the surrounding area to enhance the public consultation process.

Resident 1

First and last name

Address

Telephone

Save information

Save the information and complete the form later.