Imlay City, MI · Lapeer County
Sewer Back-Up Notice of Claim
This notice form lets claimants provide Imlay City with information about damage or physical injury arising from a sewage disposal or storm water system event.
What this form is
Claimants use this form to give written notice of a claim for damages or physical injury arising from a sewage disposal or storm water system event. It asks for the claimant’s name, contact information, affected property address, a brief description of the claim, and the date the damage or injury was discovered. The form states that notice must be provided within 45 days after discovery, or when it reasonably should have been discovered.
Who needs it
A person claiming property damage or physical injury from a sewage disposal or storm water system event should provide this written notice.
How to submit it
Return the completed form to the designated person at your governmental agency. The form does not provide a specific address or submission email.
About notarization
This document is completed without a notary; it requests a date and claimant information, and identifies no notarized attachment or sworn step.
How to submit this form
- 1
Download the Form
Download the Sewer Back-Up Notice of Claim PDF.
- 2
Complete the Claim Details
Enter the requested contact and affected-property details, describe the claim, and provide the date the damage or injury was discovered.
- 3
Return the Form
Return the completed form to the designated person at your governmental agency.
Frequently asked questions
- What is the Sewer Back-Up Notice of Claim used for?
- It provides written notice of a claim for damages or physical injury arising from a sewage disposal or storm water system event.
- Do I need a notary for the Sewer Back-Up Notice of Claim?
- No. The form requests a date and claimant information and identifies no notarized attachment or sworn step.
- How do I submit the Sewer Back-Up Notice of Claim?
- Return the completed form to the designated person at your governmental agency. The form does not list a specific address or submission email.