PROPERTY OWNER FORM
TERMS OF VILLAGE SERVICES
(Read carefully before signing):
I/We hereby request that the Village of River Grove commence water and sewer service and/or refuse
services at the above identified property on or after .
I/We understand that the water used at the premises shall be registered and measured by meter. If a
meter fails to register the quantity of water that passes through it at any time, then the quantity shall be
determined and charged based upon the average quantity registered during such preceding period of
time prior to the date of failure. No deductions shall be made from bills on the account of leakage. I/We
also understand that sewer services provided by the Village shall charged based upon the metered
water usage, and further that if applicable refuse services provided through the Village shall be provided
on a weekly basis. I/We understand that I/we must comply with all ordinances regarding sewer and
refuse services, and that I/we shall pay the standard monthly service fees to the Village.
I/We hereby acknowledge that all persons signing this application shall be jointly and severally
responsible for the payment of any water, sewer and/or refuse services supplied by the Village of River
Grove or its agents as a result of this application until written notice is given to the Village at least ten
(10) days in advance of the date that such services be terminated by the Village of River Grove.
By making this application and signing below, I/We hereby authorize the Village to shut off and
terminate all water services and/or refuse services without notice if any bill for such services is not paid
within sixty (60) days of its due date. I/We understand that partial payment of any amount due and
owing the Village of River Grove shall not toll the sixty (60) day period without an express written
agreement signed by a duly authorized officer of the Village of River Grove. I/We also understand and
agree that the supply of water and water services may be stopped until all arrearages and the sum of
Fifty Dollars ($50.00) for shutting off and turning on water are paid in full to the Village of River Grove.
In the event that the Village of River Grove is required to commence a civil action to recover money due
for water, sewer and/or refuse services rendered, I/We agree that the Village of River Grove shall be
entitled to recover the judgment amount, plus costs and expenses, including reasonable attorney’s fees,
incurred in collecting said money from any or all persons signing this application.
By my/our signature(s) below, I/we hereby represent that the information provided in this application is
true and correct to the best of my/our belief; that I/we understand that this property is located within the
zoning district indicated above, and that any conversion or use of this property in violation of the zoning
code of the village shall subject me/us to corrective action by the village. This is includes, without
limitation, the conversion of a single family dwelling unit into a multi-family dwelling unit in violation of the
village code, that would require the removal of any unlawful dwelling units upon complaint to or
inspection by the village. In the event the village is required to commence legal action to ensure my/our
compliance with the zoning code of the village and the court determines that a violation exists, I/we
understand that I/we shall be responsible for the cost of all corrective actions, plus the court costs,
including reasonable attorney fees, the village incurs in taking such action.
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Owner’s Signature (Required) Printed name
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Occupant’s Signature Printed name
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Authorized Party’s Signature Printed name
Sep 2018
