Forms • Fox Lake, IL • CivicEngage

Public Form For Reporting Flood Damage

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Impact Location (The specific location where this flood impact occurred or is occurring)*

Location Type. (What type of location was impacted?)*

Damage Description (What Impacts Happened at this Location? Mark all that apply.)

	First Floor or Higher Flooded
	Sewer Backup
	Structural Damage from Falling Tree
	Structural Damage from Flooding

Degree of Impact (How severe is the impact to the location?)*

Insured? (What kind of insurance (if any) covers the location?)*

Contact Information (What is the NAME/NUMBER/EMAIL of the person we can contact for more information about this impact?)*

* indicates required fields.