Report Damage to Parks
Use this form to report any damage to parks located within the City of Belen. Please complete all information including your name, phone number and e-mail address so that someone from our staff can contact you if necessary. This information will be forwarded to the appropriate department as soon as it is received.
Date:
Name:
Address:
Phone Number:
E-Mail Address:
Would you like to be contacted?:
Yes
No
Location of park:
Check the damaged items:
Curbs/Sidwalks
Fencing
Pothole
Sprinkler
Restroom
Sewer
Litter
Lights
Playground
Field Damage
Hazardous Parking
Other
Brief description of damage:
