1. RESP. ID # _______________
Office use only
Housing And Neighborhood Development Services, City of Palm Bay
COMMUNITY 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 CATEGORY
HOUSING – UP TO 3 CHOICES HUMAN SERVICES – UP TO 3 CHOICES
Affordable rental units Food banks/food programs
Rental assistance Drug/alcohol treatment
Affordable housing available for purchase Public transportation
Purchase assistance for first-time homebuyers Prescription purchase assistance
Help with housing for people with special needs Health services
Domestic violence shelters Mental health services
Emergency shelters/homeless facilities Senior services
Help with home repair Handicap/disability services
Foreclosure prevention assistance Affordable child care
After school programs
COMMUNITY APPEARANCE – UP TO 3 CHOICES Youth Services
Abandoned cars and junk in yards Family counseling
Litter and junk on vacant lots and roadsides Help with homelessness
Overgrown lots, yards and roadsides Recreation programs
Abandoned/dilapidated homes
Commercial vehicles parked in residential neighborhoods PUBLIC FACILITIES – UP TO 3 CHOICES
Rundown buildings other than homes Park facilities
Business storefronts that need improvement Senior centers
Community centers/meeting places
ECONOMIC/JOB DEVELOPMENT – UP TO 3 CHOICES Youth centers
Employment opportunities Child care facilities
Job placement services Health facilities
Job training Bus stop shelters/benches
Higher paying jobs Wheelchair/handicap accessibility
Small business assistance
INFRASTRUCTURE – UP TO 3 CHOICES
PUBLIC SAFETY – UP TO 3 CHOICES Pave roads in neighborhoods
Gang issues/gang violence in neighborhoods Improve hazardous intersections
Drug sales in neighborhoods Widen main roadways
Loud music/noise in neighborhoods Street lights
Fire protection Sidewalks
Police presence/protection Fire hydrants
Speeding in neighborhoods Flood/drainage improvements
Safer 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 by
July 15, 2015

2. 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 MAIL
1. 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 side
showing.
INSERT BRM