Water Service Request Form

Water Service Request

Email page link

Water Service Request Form

Water Service Request

* - Required Field

Name

Address of Service

Apartment Number (if applicable)

Reason for Water Service Request

Phone Number *

Date Service Requested *

For Emergencies Call 815-987-5712

Time Service Requested *

Brief Description of Request

E-mail Address

For a Water Emergency, Please Call 815-987-5712

Page last updated: 5/14/2012 8:30:18 PM

Permits | Report a Problem | Employment | Contact Us