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Sustainable Practices Request Form
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Sustainable Practices Request Form
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5/30/2012 5:50:16 PM
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<br />Green Practices Commission <br /> <br />6801 Delmar Boulevard, University City, Missouri 63130, Phone: (314) 862-6767, Fax: (314) 863-9146 <br />GREEN PRACTICES COMMISSION <br />SUSTAINABLE PRACTICES REQUEST FORM <br />STATE THE NATURE OF YOUR REQUEST: <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />WHAT ACTION ARE YOU REQUESTING THAT THE CITY TAKE CONCERNING YOUR <br />REQUEST?_________________________________________________________________ <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />WHAT IMPACT WOULD THE ACTION HAVE ON THE COMMUNITY? (PLEASE BE <br />SPECIFIC)__________________________________________________________________ <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />LOCATION OF REQUEST (IF APPLICABLE): <br />___________________________________________________________________________ <br />___________________________________________________________________________ <br />NOTE: The Public Worksand ParksDepartment staff will review this request and, if warranted, <br />this matter will appear as an agenda item for a Green Practices Commission meeting. If a <br />meeting is held, you will be encouraged to attend so that you may state your concerns. <br />NAME:_____________________________________________________________________ <br />ADDRESS:__________________________________________________________________ <br />PHONE (DAY):_________________ PHONE (HOME/MOBILE):________________________ <br />Email:______________________________________________________________________ <br />Date:__________________________ <br />Please return the completed form <br />to Lynnette Hicks, Public Works Liaison of the Green <br />rd <br />Practices Commission, at the Public Works and Parks Department, 3floor of the City Hall. <br />Or, by mail/fax:Green Practices Commission <br />C/O Public Worksand ParksDepartment <br />rd <br />6801 Delmar Blvd. 3Floor <br />University City, MO 63130 <br />(314) 862-0694 fax -(314) 505-8567 office <br />
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