Property Owner Information. Indicate the person(s) or organization(s) who own the property proposed for development. Attached additional sheets if there are multiple property owners. Name (Individual or Organization): Mailing Address: Daytime Telephone: Fax: Email or Alternative Contact Information: Description of the request: (attach additional sheets if necessary):
Property Owner Information. All property owners must provide their driver’s license for HAWL office to photocopy. Centralized sewer is owned and operated by the Pearl River County Utility Authority. The fee for this utility service charge is added to the HAWL monthly statement (see Property Owners Manual for current rate schedule). Sewer hook up will be mandatory for all new construction. For homes with existing septic tanks/treatment plants, tying into the central sewer system is not mandated provided the existing system is found to be operating adequately during regular inspections. Name Social Security Number Date of Birth Employer’s Name Employer’s Address Employer’s Phone Number Resident Information - All other occupants aside from property owner(s). Name Relation to Property Owner Date of Birth 1st Phone Number (Will Receive Emergency Alerts) 2nd Phone Number(Will Receive Emergency Alerts) 3rd Phone Number(Will Receive Emergency Alerts) 4th Phone Number (Will NOT Receive Emergency Alerts) 5th Phone Number (Will NOT Receive Emergency Alerts) Email Address - Provide two of the property owners’ primary email addresses. The email address provided will be used solely for Hide-A-Way Lake correspondence and for the alert system for homeowners. This email will not affect information on file for online ACH bill payments. 1st Email Address 2nd Email Address
Property Owner Information. Property Owner Name Mailing address of Property Owner Property Owner Phone Number(s) Property Owner Email Address Property Owner Signature Date Property Access Approval of a Rental or Tenant Occupied Location6 Name of Occupant/Tenant Occupant/Tenant Phone Number Occupant/Tenant Email Address Occupant/Tenant Signature Date 5Must be completed and returned before installation begins.
Property Owner Information. Property Owner Name (Firm name or individual): Phone No.: (As appears on Assessor rolls.) (Property Owner Name must match page 1.) If Firm Name, list contact person: Email: Address: Fax No.:
Property Owner Information. Check here if same as Applicant 🡪 □ * If more than one owner, attach additional sheet with names and addresses. Company (if applicable): Name: Mailing Address: City: State: Zip Code: Phone #: Fax #: Mobile #: E-mail: Engineer/Architect/Planner: * Check here if same as Applicant 🡪 □ Company (if applicable): Name: Mailing Address: City: State: Zip Code: Phone #: Fax #: Mobile #: E-mail:
Property Owner Information. (If Different from Applicant) (Property Owner Name) (Mailing Address) (Email Address) (Phone Number) (Emergency Phone Number) I certify that all the information provided above and the information contained in any documents submitted herewith is true and accurate. I consent to the entry in or upon the property described in this application by any authorized official of the City of West Chicago for the purposes of inspection or review of the site to provide information for the formal determination of the license agreement. _ (Signature of Applicant) (Date) (Signature of Property Owner) (Date) PLEASE READ City of West Chicago Seating in Public Right-of-Way Requirements and Regulations
Property Owner Information. All property owners must provide their driver’s license for HAWL Office to photocopy.
