Transportation - Petition for Street Name Change

Mail to: P.O. Box 1090 - Riverside, CA 92502
ATTN: STREET NAMES

All property owners abutting ___________________________________________________

located between________________________________ and __________________________

are hereby given the opportunity to sign this petition to evaluate if a street name
should be changed.

What is the reason for requesting the name change?

________________________________________________________________________

Petitioner's Name: ________________________________________________________

Address: ______________________________________________________________

_____________________________________________________________________

Telephone (______) _________________________________________

NAME/ADDRESS	ASSESSOR'S PARCEL NO.	APPROVAL YES/NO	SIGNATURE & PHONE
_______________________________ _______________________________	_________________	_________	_______________________ _______________________
_______________________________ _______________________________	_________________	_________	_______________________ _______________________
_______________________________ _______________________________	_________________	_________	_______________________ _______________________
_______________________________ _______________________________	_________________	_________	_______________________ _______________________
_______________________________ _______________________________	_________________	_________	_______________________ _______________________
_______________________ _______________________
_______________________________ _______________________________	_________________	_________	_______________________ _______________________