Westwood Neighborhood Survey

Question Title

* 1. What is your Address

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

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* 2. Do you own or rent?

Own

Rent

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* 3. How would you rate the following in your neighborhood:

	1 - Bad	2	3 - Fair	4	5 - Good
The conditions of the streets	The conditions of the streets 1 - Bad	The conditions of the streets 2	The conditions of the streets 3 - Fair	The conditions of the streets 4	The conditions of the streets 5 - Good
The ability for water to drain from the streets	The ability for water to drain from the streets 1 - Bad	The ability for water to drain from the streets 2	The ability for water to drain from the streets 3 - Fair	The ability for water to drain from the streets 4	The ability for water to drain from the streets 5 - Good
Street lighting	Street lighting 1 - Bad	Street lighting 2	Street lighting 3 - Fair	Street lighting 4	Street lighting 5 - Good

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* 4. Have issues with drainage or standing water ever directly impacted you?

Yes

No

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* 5. Have issues with other elements of the neighborhood's City infrastructure (streets, sanitary sewer, water mains, or street lighting) ever directly impacted you?

Yes

No

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* 6. Do you feel infrastructure improvements are necessary in your neighborhood?

Yes

No

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* 7. Additional comments/feedback about the infrastructure in your neighborhood.