CITY OF LITTLE ROCK

Infrastructure Project

Request Form

Infrastructure Project Request Form

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Contact Information (Name) *

Email *

Phone Number *

Street Address *

Consent Briefly location

Zip Code *

Project Information:

• Street(s)
• Sidewalk(s)
• Drainage
• Resurfacing
• Traffic Signal
• Other

Comment

Use this section to briefly describe your project if other was chosen.

What is the location of the project? *

Street name, address, and boundaries

Briefly describe your project

Example: Apple street is narrow and in poor condition. Needs curbs and sidewalk.

Select the best answer to describe your project

• This is a new project
• Continuation of existing project

If this is a continuation, what project is it a continuation of?

Consent for storing submitted data *

• Yes, I give permission to store and process my data
• No, I don’t consent to storing and processing my data

Submit