Q. Is the mailing address same as the affected address?
A. Yes

Q. Do you have a Basement, Crawl Space or Utility Room?
A. Basement

Q. Is the Water backing up through the floor drain?
A. Yes

Q. Is the Water clear or is there raw sewage?
A. Dark Water

Q. Is your basement still flooded?
A. No

Q. Are you Disabled or a Senior Citizen that Needs Assistance?
A. No

Q. Do you have large items that require 2 or more people to move?
A. No

Q. Do any of your neighbors on your side of the street have water back up also?
A. Yes

Q. Date of damage?
A. 28 czerwca 2021 14:18

Q. Do you have a child under 10 in the house?
A. Yes

Q. Do you need cleaning sanitation services?
A. No

Q. Additional Information
A. The flooding happened the day we had that big rain fall and all the flooding in MI. I cannot remember the exact date but I had water flowing out of one of the drains in my basement that caused more than 4 inches of water to be sitting in my basement