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THIS IS TO BE COMPLETED BY THE REPRESENTATIVE SEEKING A FLOOD DEBASEMENT. EACH PARCEL NUMBER REQUIRES A NEW FORM. YOU MUST ALSO ATTACH A FLOOD CHART AND AN AERIAL MAP, WHICH ARE AVAILABLE AT THE CCAO OFFICE.
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FLOOD HISTORY RECORD
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Parcel Number Date
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Name Address
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Phone Email Address Signature
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Past 10 Years |
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Did cropland flood? yes/no |
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Source of flooding? |
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Months flooding occurred? |
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Type of crop planted |
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Number of acres planted |
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% of crop loss |
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Comments:_____________________________________________________________________________________________
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