Report an Incident

Use this form to report a residential sanitary sewer or water-in-basement incident (link is external). Please use the online form so (1) we have a record of your submission and (2) you will receive a full copy of it in your email. But you can request a paper form from mayor [at] minervapark.org

Contact Information

First Name

Last Name

Street Address

Phone Number

Location (if different from above)

Date & Time Incident Began (if known)

Date Incident Began

Time Incident Began

Date & Time Incident Ended (if known)

Date Incident Ended

Time Incident Ended

Sewer Component

Basement Drain

Sewer Pipe

Manhole

Other

Did water or sewage come up from the basement drain?

Yes

If yes, did a sump pump discharge this material into the street?

Yes

Additional Comments