Planning and Coordination
ENGINEERING SERVICES DEPARTMENT
APPEAL/COMMENT FORM
The City of Tulsa appreciates your input on the Revised Preliminary Digital Flood Insurance
Rate Map (DFIRM) that the Federal Emergency Management Agency (FEMA) has released,
for public review and comment in cooperation with the Oklahoma Water Resource Board.
Your comments and appeals will be used to correct any errors or oversights prior to the
adoption of the updated maps.
Name ________________________________ Phone Number: __________________
Mailing Address _________________________________________________________
Physical Address of Property in Question ____________________________________
Section __ Township __ Range __ Lot/Tract___ Geocode_______________________
PROPERTY LOCATED IN (circle one): Tulsa, Rogers , Wagoner County
FEMA MAP PANEL NUMBER ______________________________
PLEASE IDENTIFY THE TYPE OF OBJECTION:
____ Appeal: Technical Issue (e.g.; elevation)
____ Comment: Map Error (e.g.; street name, city limit boundary, etc.)
FOR COMMENTS PROVIDE A DETAILED DESCRIPTION OF THE ISSUE:
_______________________________________________________________________
_______________________________________________________________________
Continue on the reverse side if needed.
FOR APPEALS PROVIDE A DETAILED DESCRIPTION OF THE ISSUE &
ATTACH SUPPORTING DOCUMENTS TO THIS FORM:
(elevation certificate, topographic maps, engineering study, photograph of flood event,
etc.)
_______________________________________________________________________
_______________________________________________________________________
September 2015 Continue on the reverse side if needed.
Please send all forms to: Bill Robison at the address below or email to
brobison@cityoftulsa.org
2317 South Jackson Avenue  Tulsa, OK 74107  Office 918.596.9475  Fax 918.596.9708
www.cityoftulsa.org