Water/Sewer/Refuse Service ApplicationService Address:Closing Date:Owner's Name:Owner's Bill to Address:Owner's City:Owner's State:Owner's Zip Code:Owner Contact Phone Number:Owner Email:Renter Move in Date:Renter's Name:Renter's Bill to Address:Renter's City:Renter's State:Renter's Zip Code:Renter's Contact Number:Renter's Email:Applicants Previous Address (Only if in Village)I agree to pay bills and service charges in accordance with Village ordinances. I guarantee that the above information is complete and correct to the best of my knowledge. I agreeForm is currently unavailable for maintenance. Please call the Village Hall at 815-725-2150