RESP. ID # _______________ Office use only

Housing And Neighborhood Development Services, City of Palm BayCOMMUNITY SURVEY

The Housing And Neighborhood Development Services (HANDS) division of the City of Palm Bay, in conjunction with the Brevard County HOME Consortium, is conducting a survey to identify community priorities for the expenditure of Federal and State assistance to low and moderate-income families/households. The survey results will be one tool used to develop the 2016 – 2021 Consolidated Plan that prioritizes the expenditures of these funds. Please help us by completing the survey. Your responses will remain anonymous. Check the box in front of each community priority in the list below that is important to you or your household (YOU MAY SELECT UP TO 3 CHOICES IN EACH CATEGORY) as well as, the household information at the end of the survey. Use the box at the bottom of the page to list any community priorities that you believe should be added to the list. Persons with disabilities or non-English speaking respondents, needing assistance completing the survey, should call the Housing And Neighborhood Development Services office at (321) 952-3429.

COMMUNITY PRIORITIES BY CATEGORY COMMUNITY PRIORITIES BY CATEGORYHOUSING – UP TO 3 CHOICES HUMAN SERVICES – UP TO 3 CHOICESAffordable rental units Food banks/food programsRental assistance Drug/alcohol treatmentAffordable housing available for purchase Public transportationPurchase assistance for first-time homebuyers Prescription purchase assistanceHelp with housing for people with special needs Health servicesDomestic violence shelters Mental health servicesEmergency shelters/homeless facilities Senior servicesHelp with home repair Handicap/disability servicesForeclosure prevention assistance Affordable child care

After school programsCOMMUNITY APPEARANCE – UP TO 3 CHOICES Youth ServicesAbandoned cars and junk in yards Family counselingLitter and junk on vacant lots and roadsides Help with homelessnessOvergrown lots, yards and roadsides Recreation programsAbandoned/dilapidated homesCommercial vehicles parked in residential neighborhoods PUBLIC FACILITIES – UP TO 3 CHOICESRundown buildings other than homes Park facilitiesBusiness storefronts that need improvement Senior centers

Community centers/meeting placesECONOMIC/JOB DEVELOPMENT – UP TO 3 CHOICES Youth centersEmployment opportunities Child care facilitiesJob placement services Health facilitiesJob training Bus stop shelters/benchesHigher paying jobs Wheelchair/handicap accessibilitySmall business assistance

INFRASTRUCTURE – UP TO 3 CHOICESPUBLIC SAFETY – UP TO 3 CHOICES Pave roads in neighborhoodsGang issues/gang violence in neighborhoods Improve hazardous intersectionsDrug sales in neighborhoods Widen main roadwaysLoud music/noise in neighborhoods Street lightsFire protection SidewalksPolice presence/protection Fire hydrantsSpeeding in neighborhoods Flood/drainage improvementsSafer school bus stops City water/sewer service hook-up assistance

OTHER COMMUNITY PRIORITIES (WRITE-IN ANY IMPORTANT COMMUNITY PRIORITIES NOT LISTED ABOVE.)

HOUSEHOLD SIZE/COMBINED HOUSEHOLD INCOME/PALM BAY RESIDENCE HOUSEHOLD SIZE COMBINED HOUSEHOLD INCOME PALM BAY RESIDENCE 1 Person 6 Persons <$34,650 >$53,500 to $57,450 Northeast Palm Bay 2 Persons 7 Persons >$34,650 to $39,600 >$57,450 to $61,400 Northwest Palm Bay 3 Persons 8 Persons >$39,600 to $44,550 >$61,400 to $65,350 Southeast Palm Bay 4 Persons 9 Persons >$44,550 to $49,500 >$65,350 to $69,300 Southwest Palm Bay 5 Persons 10 or More >$49,500 to $53,500 >$69,300

Please return byJuly 15, 2015

THANK YOU for completing the survey. Please follow the mailing instructions on the reverse side to return the completed survey to the City of Palm Bay or drop off the survey at the Growth Management offices located on the 2nd Floor of the City Hall Annex Building at 120 Malabar Road, S.E., Palm Bay, FL 32907. NO RETURNED SURVEYS CAN BE ACCEPTED AFTER JULY 15, 2015.

PLEASE REFOLD & SECURE W/SCOTCH TAPE BEFORE RETURNING BY MAIL1. 2. 3. 4. 5. 6.

Unfold survey to lie Survey is now facing up Raise ends in Fold down top, then Secure w/tape, Drop in U.S. Mail.flat on table. while lying flat on table. the shape of a fold down bottom, so No Staples. No postage necessary.

“U” that the address label is the only printed sideshowing.

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