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PROPERTY OWNER DRAINAGE CONCERN FORM

Romeoville Public Works Department
Instructions:
The property owner permits the Village of Romeoville and its representatives to access the property for the purpose of investigating the concern and obtaining information necessary to propose possible remedies. In addition to a general assessment of the conditions, other activities that may be conducted include topographical surveys, utility surveys, etc.
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INFORMATION REGARDING CONCERN
Describe the issue specifically and include any information regarding the presence of any of the following:
1.) The extent of any property damage, including an estimate of the repair costs
2.) Water in the basement, the location of entrance into the basement and the depth; the location of any sump pumps and discharge pipes, and the condition of the pumps and pipes before and after the occurrence, and any information regarding any prior occurrences
3.) Standing water, the extent of the area, the duration of the issue and the frequency of occurrence
4.) Any hazards or safety issues
Description of any prior attempts to alleviate the issue, or suggestions as to how the issue may be alleviated
List and attach any available documentation that may be useful in assessing the issue, such as photos, video, sketches, plats of survey, etc.
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Today's Date*
Today's Date
Owner's Name*
The property owner permits the Village of Romeoville and its representatives to access the property for the purpose of investigating the concern and obtaining information necessary to propose possible remedies. In addition to a general assessment of the conditions, other activities that may be conducted include topographical surveys, utility surveys, etc. *
1. I agree

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