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Residential Input Form

  1. Can we contact you regarding your response?*
  2. Have you experienced chronic or prolonged flooding conditions at your address or your area?*
  3. Which of the following best describes your condition*
  4. Have you reported the flooding conditions experienced by you at your property or area to the city?*
  5. Are you aware of the city’s flood complaint report form?*
  6. Have you experienced any damages or financial expenses resulting from flooding conditions?*
  7. Have you filed any claim with your insurance company regarding any damages to your property resulting from the flooding conditions?*
  8. If so, Did your insurance provide adequate coverage for your damages?
  9. Which of the following describes the extent of damages*
  10. Will you be willing to provide more feedback to the city in seeking solutions and mitigating flooding conditions*
  11. Will you attend future public meetings scheduled to provide information on the city’s progress in addressing the storm water management issues*
  12. Leave This Blank:

  13. This field is not part of the form submission.