Thank You for Your Submission

2. FOR IMMEDIATE ASSISTANCE

   If you experience a sewer backup in your basement or a water leak inside your home, please contact the Utility Department at 763-421-0154 (7:00 a.m. – 2:30 p.m. Monday – Friday).  After hours, contact Hennepin County Dispatch at 952-258-5321. 

4. Primary Issue*
   -- Select One --Sanitary SewerWater Issues
6. Please Select One of the Following Sewer Options*
   -- Select One --Having Sewer Line CleanedUnusual OdorOther
8. Please Describe Situation*
10. Please Select One of the Following Water Options
    -- Select One --Water LeaksUnusual Taste/Odor/ColorNo WaterLower PressureStanding Water/Water Main BreakOther
12. Please Describe Situation*
14. Address Where Issue Is Taking Place*
16. Best Time of Day to View the Issue (If Applicable)
    Best Time of Day to View the Issue (If Applicable)

    Best Time of Day to View the Issue (If Applicable)
18. Best Way to Contact You
    -- Select One --PhoneEmail
20. First Name*
21. Last Name*
23. Your Email Address*
24. Your Phone Number*
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26. 1. Receive an email copy of this form.
27. Email address

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28. Submit

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