2. 

3. WATER/REFUSE UTILITY SERVICE APPLICATION 

   FOR CLARENDON HILLS

5. Village Needs Two Business Days to Process (M-F)
7. Water/Refuse Utility Account Move In Request

   1. When setting up an account, please keep in mind that the Village needs two business days (Monday-Friday) to process requests. If you have any questions, please contact the Finance Water Department at 630-286-5416.

11. Closing Date/ Lease Start Date*
    Closing Date/ Lease Start Date
12. Clarendon Hills Service Address (Be sure to include Suite/Apt/Unit number if applicable.)*

    Clarendon Hills, IL 60514

14. Will you Own or Rent this Property?

    1. Own
    2. Rent
16. Property Owner Name*
17. Owner Email Address
19. Owner Address
21. Owner City
22. Owner State
23. Owner Zip Code
25. Owner Phone Number*
27. Are you moving from another Clarendon Hills Address or had a prior account with the Village?*

    1. No
    2. Yes
29. Enter your Previous Utility Account Number or Clarendon Hills Address*
33. Water/Refuse Utility Account Information

    The Water/Refuse Utility account will be assigned to the information provided below .

35. Account Holder First Name*
36. Last Name*
38. Email Address*
39. Phone Number*
41. Additional Account Holder First Name (optional)
42. Additional Account Holder Last Name (optional)
44. Additional Account Holder's Phone Number
45. Additional Account Holder's Email Address
49. REFUSE FOR RESIDENTIAL ONLY

    Clarendon Hills has a service agreement with Lakeshore Recycling Systems (LRS) for refuse/recycling services. The Village bills for these services on a bi-monthly basis with their water utility billing. Unincorporated properties, select condo associations, and commercial properties are not included in the Villages refuse contract and will not be billed by the Village.

50. Choose your Refuse Cart Size*

    1. 35 gallon refuse and recycling can
    2. 65 Gallon refuse and recycling can
    3. 95 gallon refuse and recycling can
52. Senior Rates

    Refuse senior rate is for residents 65+ for the 35 gallon can only and with proof of age and completion of a Senior Application found by clicking this link.  The option for the larger can sizes is available but for non discounted fee.

54. Additional Services from Lakeshore Recycling Systems (LRS)

    Other services such as backdoor services, yard waste cans, and additional cans are billed separately by LRS. For these services contact LRS at 844-633-3577 or email LRS at service@LRSrecycles.com 

58. Water/Refuse Utility Billing is being sent to*

    1. Property Owner
    2. Tenant/ Renter
    3. Property Manager
59. Billing Information*

    Choose one below.

    1. Mail my bill to my service address.
    2. Mail my bill to another address.
61. Mail my bill to this Address
63. Additional information you would like to include for the Village.
67. Terms of Agreement*

    1. By clicking this box, I agree to the terms and conditions as set out in this application and in the Village of Clarendon Hills Municipal Code.

    1. That this electronic signature is the legally binding equivalent to my handwritten signature and has the same validity and meaning. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.
       
       I understand that once submitted and the application is processed the account is active and I am responsible for the charges for this address. The utility account will be created and sent during the designated cycle. Note that each cycle is for two months of usage and that bills are mailed bimonthly.

    2. I acknowledge that this constitutes written application for utility service at the address above. Further, I acknowledge that I agree to pay charges for all services rendered as a result of this request. I understand and agree that failure to pay any amount due to the Village of Clarendon Hills can result in penalty fees and/or discontinuation of services until such time as full payment has been received.

69. Additional Information

    Questions can be directed to the Utility Billing Clerk at 630-286-5416 and/or waterbilling@clarendonhills.us

Leave This Blank:


71. 1. Receive an email copy of this form.
72. Email address

    This field is not part of the form submission.

73. Submit

* indicates a required field