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94 <br />*1a <br />e� <br />Attachment A <br />Request for the Flood and Drainage Relief <br />Name of Applicant(s) <br />Address of Applicant(s) <br />Phone Numbers: Home: Work: <br />Address of Property to be evaluated: <br />Please fill in the information requested below: <br />1. Indicate the month and year you purchased the property to be evaluated. <br />2. Is the property to be evaluated: <br />Single Family Duplex Apartment Other <br />3. 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 Date <br />Please return your application to: <br />City of St. Anthony Village City Manager <br />3301 Silver Lake Road <br />St. Anthony, Minnesota 55418 <br />