Regions 4 & 2 Planning and Development Councils - Survey of Private Water Crossings
Regarding June 22-29, 2016 Flood Event (DR-4273-WV)
Please enter a valid phone number.
Street Address Line 2
State / Province
Postal / Zip Code
For your specific location of residence, please answer the following questions:
The location of the private water crossing can be best described as: (check all that apply)
Low Water Crossing
Concrete Box Culvert
If pipe, please list diameter of pipe below if known:
If other, please describe:
Is the crossing the only access to your residence?
Do you use the crossing daily?
How many households does the crossing serve?
How many school-aged children live past the crossing?
Does a school bus pass over the crossing?
How many residents over the age of 65 live past the crossing?
Are there individuals at your residence with special medical needs?
In the event of a life-threatening emergency, can an emergency vehicle reach your home?
Is there a fire hydrant past the crossing?
Are there any businesses past the crossing?
If yes, please provide details on number and type of businesses:
To your knowledge, over the last 10 years, how often has the crossing flooded to the point that it was unpassable?
Does the crossing currently have damage and need repair?
If yes, please provide details:
Do you own the location of the crossing or have a right-of-way at the crossing?
Should be Empty: