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2. Name
3. Date
   Date
5. Your Address
7. Email Address
   Enter your email.
8. Phone Number
9. Type of Concern

   1. Standing water
   2. High water threating property
   3. Erosion
11. Location of Drainage Complaint
13. Have you previously contacted the city about drainage issues regarding this property?

    1. Yes

    1. No
14. If so, are the issues similar to the issues you are currently experiencing?

    1. Yes

    1. No
16. Type of Complaint (erosion, flooding, illicit discharge, etc.)
18. Description of the Problem (please provide as much detail as possible)
20. By submitting this form, I certify that the information is, to the best of my knowledge, correct and represents a complete and accurate statement. I agree to allow city staff or an inspector on-site to review and verify the above information (if needed).
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25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

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