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APPENDIX A – SAMPLE PETITION <br />PETITION FOR STREET NAME CHANGE FORM <br />Signature below affirms we request changing the name of our street: <br />_________________, from ____________to ____________ <br />\[current street name\]\[intersecting street\]\[intersecting street\] <br />And recommend consideration of the new name: __________________________. <br />\[preferred new street name\] <br />The petitioners ask the City of Roseville to review this request and put it before the City Council for <br />consideration at an upcoming Council meeting. Note to petitioners: a public hearing would be held <br />prior to adoption of a new name that may or may not be the recommended name noted above. <br /> Name Address Signature <br /> <br />1 <br /> <br />2 <br /> <br />3 <br /> <br />4 <br /> <br />5 <br /> <br />6 <br /> <br />7 <br /> <br />8 <br /> <br />9 <br /> <br />10 <br /> <br />11 <br /> <br />12 <br /> <br />13 <br /> <br />14 <br /> <br />15 <br /> <br />16 <br />Street Name Policy – March 2024 <br />Qbhf!328!pg!342 <br /> <br />