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2. WHEREAS, the Village of Hanover Park requires that a dwelling be occupied at the time that the water service is turned on to that dwelling; and WHEREAS, the undersigned has requested that the water service be turned on when the dwelling is unoccupied; 

   NOW, THEREFORE, in consideration of the Village of Hanover Park turning on the water to the dwelling at:

4. Service Address*
6. City*
7. State*
8. Zip Code*
10. Owner's Name*
11. Phone Number*
13. Driver's License Front*
15. Email*

17. Agrees to hold harmless the Village of Hanover Park from and against all suits, damages and losses resulting from or caused by said turn-on.

19. Today's Date*
    Today's Date
20. Owner's Name*

    DISCLAIMER: By typing your name here, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

22. If you want to restore water service at an unoccupied property, please complete the “Turn-On Waiver”. Waivers must be received before 3 pm Monday – Friday for same-day restoration. If the waiver is received after 3 pm, water will be restored the next business day.  

     

    Please note: We can only accept waivers completed by the property owner.

Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field