This questionnaire is used to gather information to assist in determining drainage needs throughout the City. Please do not request information or a site visit using this form. If you would like to talk to a City representative, please call 817-459-6550 or submit an Ask Arlington request.
Name
Address of property
Street Address
Address Line 2
City
State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
ZIP Code
Email
Has water ever entered your home during a rain event? YES NO
If yes, how many times has your home flooded?
What was the last date that you flooded?
Has water ever caused damage to your property(yards, vehicles, retaining walls, etc.) during a rain event? YES NO
If yes to either of the above questions, where did the water come from? (select all that apply)
Street
Neighbors Yard
Creek Channel
Alley
Do you own the property? YES NO
If yes, how many years have you owned the property?
Are you aware of any flooding on other nearby properties? YES NO
If yes, what is/are the address(es)?
Additional Comments