Preliminary Damage Assessment Survey (Flood)

THIS IS NOT AN APPLICATION – The information you provide will assist St. Louis County is creating a Preliminary Damage Assessment to be submitted to the State of Minnesota and the Federal Emergency Management Agency (FEMA) to determine if and what types of assistance may be available.
Please complete the following information to the best of your ability, any questions or to obtain this survey by mail please call St. Louis County Emergency Management at 218-625-3960 or leep@stlouiscountymn.gov

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* 1. Address of affected property.

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* 2. Is this property

Single Family

Multi Family

Manufactured Home

Recreational Property

Business

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* 3. Is this your primary residence?

Yes

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* 4. Please provide contact information for the owner of this property.

Name

Mailing Address

Phone

Email Address

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* 5. Please indicate level of damage using the following categories:

Affected – Minimal flooding with less than 3 inches of water in an occupied or required room.

Minor – Three to eighteen inches of water in an occupied or required room. Damage or disaster related contamination to private well or septic system.

Major - Eighteen inches or more of water on the first floor or water that covers electrical outlets. Homes with a basement may be considered for major damage if the water level has compromised the structural integrity of the home.

Destroyed - Complete failure of two or more major structural components (e.g., collapse of basement walls/foundation, walls or roof)

Preliminary Damage Assessment Survey (Flood)

Question Title

* 1. Address of affected property.

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* 2. Is this property

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* 3. Is this your primary residence?

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* 4. Please provide contact information for the owner of this property.

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* 5. Please indicate level of damage using the following categories:

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* 6. Do you have a damage estimate?

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* 7. Have you filed an insurance claim?