APPLICATION FOR STREET NAME CHANGE
County of Riverside Transportation Department
Survey Division
RIGHT-OF-WAY SECTION
(951) 275-6700
Located at 4080 Lemon Street, Eighth Floor
Mail to: P.O. Box 1090 - Riverside, CA 92502
ATTN: STREET NAMES
ATTN: STREET NAMES
Please fill out form and attach a copy of your Assessor's map marking the location of your parcel and the street you wish to rename.
| Your Name: _______________________________________________________________
Address: Residence: ______________________________________________________________ Mailing: _______________________________________________________________ Telephone (______) _________________________________________ Current Street Name:_____________________________________________________ What is the reason for requesting the name change? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Before completing, see Street Name Change Policy. List six choices for a name. (Please list in order of preference and do notuse the same root word for selections) 1) __________________________________ 4) __________________________________ 2) __________________________________ 5) __________________________________ 3) __________________________________ 3) __________________________________ |
| Note: The six choices are subject to approval by the Riverside County Transportation Department |
| APPLICANT'S SIGNATURE: _______________________________________________
Date: ______________________________ |