GENERAL INFORMATION

Agency / Business Name: ___________________________________________________

Mailing Address: ___________________________________________________________

Contact Person: _______________________ Phone:____________ Fax: ____________

Nature of Business / Agency: ________________________________________________

Number of Employees: _____________________________________________________

Location(s) of Locker/Rack: _________________________________________________

Briefly describe the need for bicycle parking and who is expected to use the facilities (e.g., employees, patrons, students). How many people per day, for how long each day, on average, will use the facilities?

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

The use will be primarily: (check all that apply)

____ Weekday, ____Weekend, ____Daytime, ____Nighttime

Please indicate the quantity of each:

____Inverted "U" Racks - 3 spaces   ____Bicycle Locker with window - 2 spaces
____Wave Rack - 7 spaces
                                                    Total _________

I certify that this is private property or, if leased, the owner has given permission to install bicycle racks/lockers at the locations(s) above. Please submit letter of permission from owner or permit if this is public property.

Name and Title:_______________________________________________

Signature: _________________________________Date:______________

  Return this application as soon as possible to:

City of Salinas, Public Works
200 Lincoln Avenue, Salinas 93901
or fax to: (831)758-7935.

Please call James Serrano or Hilda Garcia at (831) 758-7241 with any questions you may have regarding this application or the program.