Form Center

Site Information

Instructions
1. Fill out this form completely. A separate application must be made for each individual parcel. One application can be made for multiple stormwater detention/retention facilities to be inspected on the same property. Attach (or provide) a separate sheet giving parcel location, description and number(s) for each parcel for which you are requesting evaluation. 2. Fill out and provide a Right-of-Entry Form (Form 3).
Site Location - Street Address1
City
State
Zip
Parcel Number:
Continue

Facility Location on Site
Provide a separate sheet for each facility giving a sketch of the location and description
Upload Facility Location File
Description of Facility (i.e. pond, parking lot, etc.)
I hereby request consideration for impervious area evaluation and further authorize the City of Lima or their authorized representative(s) to inspect the above-identified stormwater facility(ies) for the purpose of investigation for a stormwater service fee adjustment. I certify that I have authority to make such a request and authorization for this property.
Electronic Signature*
By checking "I Agree" you agree and acknowledge your electronic signature is valid and binding in the same force and effect as a handwritten signature.
1. I Agree
Date
Date
Upload Right-of-Entry Form (Form 3)

Leave This Blank: