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Information logged in Traffic Service Requests SmartSheet ®? ___Yes ___No <br />Assigned Traffic Service Request Number: TR _____-________ <br />Thank you for submitting a traffic concern to the Engineering Office. Your request will be reviewed by our team and may <br />require further investigation, including traffic counts and speed studies. This can take several weeks so please know that <br />we are working to address your concern. <br />For Office Use Only <br />Email completed form to trafficrequest@southbendin.gov <br />CITY OF SOUTH BEND <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />TELEPHONE: <br />LOCATION OF ISSUE: <br />TRAFFIC CONCERN FORM <br />DATE: <br />NAME: <br />ADDRESS: <br />EMAIL: <br />TYPE OF ISSUE: <br />DESCRIPTION OF ISSUE: <br />TIME OF DAY IF RELEVANT: <br />Bicycle Related (Addition or revision of bicycle facility, bike lane markings, etc <br />Intersection Control (Changes at an intersection: stop sign or signal related) <br />Parking (Changes to on-street parking) <br />Pavement Markings (Missing or faded travel lane markings, traffic symbols) <br />Regulatory Sign (Addition or revision of regulatory sign such as Stop, Yield, etc.) <br />School Zone (Addition of School Zone signs, other school area traffic safety) <br />Sight Distance (Sight issues on street or intersections) <br />Signal Timing or Configuration (Changes to traffic signal timing) <br />ADA Compliance (Issues with ADA accessibility of sidewalks, street crossings, signal and other facilities) <br />Speeding (Report frequent speeding) <br />Pedestrian (Changes to crosswalk or walk signals) <br />Traffic Flow (Slow moving traffic, congestion issues, etc)