Grand Haven, MI · Ottawa County
Sewer Backup/Water Damage Claim Form
Grand Haven residents use this form to report sewer backup or water damage and submit a claim with supporting documentation to the City Clerk’s Office.
What this form is
Use this form to report a sewer backup or water damage incident and provide information for a claim to the City of Grand Haven. It asks for contact details, the incident date and location, how the loss occurred, damage descriptions and estimated costs, along with city contact history, witness information and comments. Include claim documentation such as a homeowners declaration policy, photos, estimates or receipts, and previous backup history.
Who needs it
A person reporting sewer backup or water damage to their property can complete and return this claim form to the City of Grand Haven.
How to submit it
Return the application to the City of Grand Haven Clerk’s Office, 519 Washington Avenue, Grand Haven, MI 49417. The form also lists [email protected] and fax number 616-842-0648.
About notarization
This claim form is signed and dated without a notary; it requests supporting claim documentation but does not identify any sworn or notarized attachment.
How to submit this form
- 1
Download the Claim Form
Download the Sewer Backup/Water Damage Claim Form for Grand Haven.
- 2
Complete the Form
Provide your contact details, incident information, loss description, estimated cost, and any witness or city contact information.
- 3
Gather Claim Documentation
Include claim documentation such as a homeowners declaration policy, photos, estimates or receipts, and previous backup history.
- 4
Return It to the City
Return the application to the City Clerk’s Office at the address shown on the form; the form also lists an email address and fax number.
Frequently asked questions
- Do I need a notary for the Sewer Backup/Water Damage Claim Form?
- No. The form has a signature and date line but no notary block. It requests supporting claim documentation, including a homeowners declaration policy, photos, estimates or receipts, and previous backup history.
- How do I submit the Sewer Backup/Water Damage Claim Form?
- Return it to the City of Grand Haven Clerk’s Office at 519 Washington Avenue, Grand Haven, MI 49417. The form also lists an email address and fax number.
- What information does the claim form ask for?
- It asks for contact details, incident date and address, how the loss occurred, damage descriptions, estimated cost, city department contact history, witness information and other comments.
- What supporting documents should I include?
- The form asks you to include documentation regarding your claim, such as a homeowners declaration policy, photos, estimates or receipts, and previous backup history.
Need something notarized?
This Sewer Backup/Water Damage Claim Form doesn’t need a notary — but Michigan residents can notarize other documents online with a commissioned online notary.