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Attachment A <br />Petition for the Flood and Drainage Relief <br />Name of Applicant(s) <br />Address of Applicant(s) <br />Phone Numbers: Home: <br />Address of Property to be evaluated: <br />Please fill in the information requested below: <br />1 <br />Q <br />3. <br />Work: <br />Indicate the month and year you purchased the property to be evaluated. <br />Is the property to be evaluated: <br />Single Family Duplex Apartment Other <br />Describe what happens with storm sewer overflow on your property. (Use <br />additional paper if necessary) <br />4. When storm sewer overflow has occurred, what damage has been caused? <br />(Use additional paper if necessary) <br />5. Month(s) and year(s) the damage occurred. <br />Applicant(s) Signature <br />Date <br />Please return your application to the City of St. Anthony City Manager at 3301 Silver <br />Lake Road, St. Anthony, Minnesota 55418. <br />C \USERS\BARB. SUCI U, APPDATA\ LOCALN1ICROSOFIIWINDOWS \TEPWL*9Py INTERNET FILES\CONTEAT. OUTLOOK\9ZBSSIiZOTI -00D POLICY IV ]3 DOCX <br />