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* 1. Name

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* 2. Phone (Optional)

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* 3. Email (Optional)

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* 4. Are you a resident of the neighborhoods adjacent to Lois Ave and Bay-to-Bay Boulevard?

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* 5. Do you work or own a business in the vicinity of Lois Ave and Bay-to-Bay Boulevard?

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* 6. Do you routinely cross or access Bay-to-Bay Boulevard at Lois Avenue (Select all that Apply)?

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* 7. Please provide other information you would like to share about the intersection of Lois Avenue and Bay-to-Bay Boulevard.

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