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October 2015 Flood Damage Assessment Form
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This form has been modified since it was saved. Please review all fields before submitting.
City officials are asking residents who have flood damage to contact the City to help assessment teams get an accurate count of damaged properties within the city limits.
First Name
Last Name
Address1
Address2
City
State
Zip
Phone Number
Email Address
Inches of water that flooded property
Estimated cost of damage (if known)
Description of flood damage
Please add photo of damage being reported
Please add photo of damage being reported
Please add photo of damage being reported
Please add photo of damage being reported
Please add photo of damage being reported
Do you need flood damage volunteer assistance?
Yes
No
If yes, please select the following type:
Inside clean-up
Debris removal
Structure repairs
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