Mosquito No Request Spray Form

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The City of Bellaire will give special consideration to persons who request a limited discontinuation of mosquito control adulticiding within close proximity of their residence. The commitment to completely fulfill individual requests, however, cannot be absolute. Both a concern for public health at large and other unpreventable contingencies can occasionally interfere with granting such requests.

We will, nevertheless, make every effort to accommodate the desires of our citizens whenever
possible. If you desire that we restrict adulticiding in front of your residence, please complete the
form below and return it to: City of Bellaire, 7008 S. Rice Avenue, Bellaire, TX 77401.

I, (we) request that the City of Bellaire restrict mosquito control adulticiding on public
areas in immediate proximity to my residence. I (we) further agree to allow the City of
Bellaire to notify my (our) neighbors of this restriction upon request.

Requests expire annually, and individuals who do not renew requests are removed from the
restriction list. Should you desire that a previously requested restriction be removed prior to the
annual expiration, please contact the City of Bellaire.

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