SUBMITTAL FORM If you are a human and are seeing this field, please leave it blank. * Denotes mandatory fields. Lateral Project Address Project Address * Assessor Parcel Number, if unknown click here for Marin Map. : Lateral Owner Mailing Address Lateral Owner's Name(s) * Lateral Owner Mailing Address or P.O Box * Unit or Apartment Number Lateral Owner City * Lateral Owner State * California Alabama Alaska Arizona Arkansas Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Lateral Owner Zip Code. : * Lateral Owner Phone # * Lateral Owner Email Submittee Information Submittee Name? * Submittee email address? * Submittee phone number? * Sewer Video Company Information Name of Company * Company phone number? * Check box to submit other contacts (not already listed on form) that should receive the response via email. Contact 1 Name Contact 1 Description Email 1 Contact 2 Name Contact 2 Description Email 2 Contact 3 Name Contact 3 Description Email 3 File Upload File Upload * Please upload a zipped file! This saves you time uploading and ensures all files you want to be sent are uploaded. To compress (or zip) files or a folder: 1. Locate the files or folder that you want to compress. If the file is located on a CD/DVD the file must be transferred or copied to the computers hard drive before it can be compressed (zipped). 2. Right-click the file or folder, point to Send to, and then click Compressed (zipped) folder. A new compressed folder is created in the same location. To rename it, right-click the folder, click Rename, and then type the new name. Check here to confirm how this form and video are submitted: * City Rep Internet Direct Name of person form was submitted to: Date Submitted to City Important: After submittal, please stay on this page and you will get confirmation of upload. You will also receive an email confirmation of submittal to the submittee email address. If these are received, this is confirmation your form was submitted. If there are any file error upload issues, we may not be aware of this until the upload processes and we will notify you ASAP.
