Transportation Improvement Request Form

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If there is a concern with the state of a road, bridge, MoDOT maintenance, or other MoDOT concern please use the following form to alert your Green Hills Region Transportation Advisory Committee (TAC)

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* 1. Do you have a MoDOT concern?

Yes

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* 2. In which county is the concern located?

Caldwell

Carroll

Chariton

Daviess

Grundy

Harrison

Linn

Livingston

Mercer

Putnam

Sullivan

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* 3. Type of concern

Roadway

Bridge

Sidewalk

Maintenance

Multimodal

Other (please specify)

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* 4. Please provide specific information about your concern. Be sure to include the location and a general description of the problem.

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* 5. If this is a road, bridge, or sidewalk, how often do you use in a week?

0-2 times per week

3-5 times per week

6-10 times per week

10+ times per week

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* 6. On a scale of 1 to 10 with 10 being the worst condition, what would you rate your concern?

Clear

i We adjusted the number you entered based on the slider’s scale.