City of Shakopee ADA Public Right-of-Way Transition Plan

Have prior efforts been made to resolve this complaint through the City of Shakopee grievance procedure?

Yes

No

If yes, what is the status of the grievance:

Has a complaint been filed with another bureau of the US Department of Justice, or any other Federal, State or local civil rights agency or court?

Yes

No

If yes: Agency or Court Name:

Contact Person:

Address:

City, State, Zip Code:

Telephone:

Date Filed:

Do you plan to file with another agency or court?

Yes

No

If yes: Agency or Court:

Address:

Telephone:

Signature:

Date: