2. 
4. PROJECT INFORMATION
6. Select the category that most closely relates to your request.*
   -- Select One --As-Built RecordDrainage ConcernFloodplain IssueRain GardenTraffic ConcernWetlandOther
8. For your traffic related concern, please complete the Traffic Review Committee Form by clicking this link:
   Traffic Review Committee Form
10. Project Name*
12. Project Address or Location*
14. Describe the information needed:*
16. CONTACT INFORMATION
18. Contact Name*
19. Organization
21. Phone*
22. Email Address*
24. Mailing Address*
26. City*
27. State*
28. Zip Code*
30. Property Owner Name (if different than Contact)
32. Phone
33. Email Address
35. Mailing Address
37. City
38. State
39. Zip Code
41. DOCUMENTATION
43. Upload map here
    Please upload a map showing project address or location, property boundaries, structures, and proposed project location.
45. AGREEMENT*

    1. By submitting this request, I authorize City of Coon Rapids staff to enter and inspect the property listed above. I understand it can take up to 7 business days to receive a reply to this request.
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field