City of Becker
Compliment / Concern Form

For a Police Emergency, call 911

The City of Becker is dedicated to addressing the concerns of its citizens and making the City a great place to live. This form can be used to send us a compliment or help us identify a concern in your area and address it. Please fill this form out completely and submit it online, by e-mail to kgagnon@ci.becker.mn.us or in person at City Hall or the Police Department.

This information is required for City purposes only -- you will remain anonymous and your name will not be given out publicly

Contact Information

Name:*

Telephone:*

E-mail:

Address:*

City:*

State:*

Zip Code:*

Please indicate the nature of your concern by checking the appropriate box(es) below:

Administration / Planning

Door-to-Door Solicitors

Illegal Home Occupation

Work without a Permit

Environmental

Front Yard Parking

Improper Storage

Junk/Blight

Litter

Long Grass/Weeds

Overhanging Trees/Shrubs

Parks

Bathroom Needs Cleaning

Damaged/Vandalized Equipment

Trail Needs Attention

Public Works

(For after hours emergencies, please call Public Works/Wastewater On-Call at 320-250-4526 or Sherburne Co. Dispatch at 763-765-3595)

Pothole

Traffic/Road Sign

Damaged/Leaking Fire Hydrant

Damaged Curb

Street Light Out

Storm Sewer Leaking/Blockage

Damaged Sidewalk

Traffic Signals

Water Leaking on Roadway

Loose/Protruding Manhole Cover

Road Striping

Sewer Back-Up/Sewer Issue

Snowplow Complaint/Concern

Mailbox Damage

Blocked Drainage Channel

Police

Abandoned Vehicle

Noise Nuisance

Barking Dog

Alcohol or Drug Concern

Other

Compliment a Service

Other Concern (please describe below)

Brief Description (or other concern not listed):*

Upload a Photo (optional)

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Address/Location of Concern:*

For Staff Use Only

Date:

Time:

Received by:

ICR #:

Date Completed:

Completed By: