Forms • Solon, OH • CivicEngage

Drainage Problem - Water Quality Questionnaire

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Name:*
Phone number:*
Address:*
Email:*
Is this a Water Quality Issue or a Drainage Issue? Select one:*
Description of problem:
Frequency of problem/issue?
Date first occurred/noticed?
Is it on private property or in the public right-of-way?
Circumstances causing problem, if known?
If property damage is occurring, explain:
What was done to try to solve the issue?
Did the attempted solution work?
Attached supporting information (claims, written testimony from other interested parties, pictures, sketches, etc).	Convert to PDF? (DOC, DOCX, XLS, XLSX, TXT)
Additional information:

* indicates required fields.