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2. VILLAGE OF VILLA PARK
   REIMBURSEMENT AGREEMENT
   DRIVEWAY, STAIRWELL, OR AREA DRAIN CORRECTIONS

   
   

   AGREEMENT BETWEEN THE VILLAGE OF VILLA PARK AND THE OWNER OF PROPERTY LOCATED WITHIN THE VILLAGE OF VILLA PARK PERTAINING TO DRIVEWAY, STAIRWELL, OR AREA DRAIN CORRECTIONS
4. I/we, the owner(s) of property listed below in Villa Park, Illinois wish to seek financial assistance for the disconnection of a driveway, stairwell, or other area drain from the sanitary or combined sewer system. The following procedures shall be followed and terms contained herein shall apply:
   
   

   1. I am aware that a driveway, stairwell, or area drain on my premises is connected to a sanitary or

   combined sewer in the Village of Villa Park.
   
   

   2. The Village has determined that the check valve is necessary and that this work is eligible for possible

   reimbursement under the Village’s Building Sewer Upgrade/Repair Reimbursement Policy.

   Reimbursement is subject to the availability of appropriated funds for the reimbursement program.
   
   

   3. I have obtained two written price quotations for the corrective work from a contractor pre-qualified by

   the Village. The cost estimate should itemize all costs for the corrective work. In case of an

   emergency the Village may allow a single written price quotation.
   
   

   4. The contractor or owner must obtain all necessary permits and post all necessary bonds and

   certificates of insurance as required by Village ordinances.
   
   

   5. Subject to the limitations of Paragraph 3, the Village agrees to reimburse up to $1,000 of the actual

   cost of the corrective work. Work completed without the Village’s approval of this agreement will not

   be eligible for reimbursement.
   
   

   6. The owner and/or contractor is responsible for contacting the Village to schedule any required

   inspections. Twenty-four hour notice is required. The contractor must obtain a written sign-off from an

   authorized Public Works Department employee verifying that the work is satisfactory.
   
   

   7. Any outstanding Infiltration/Inflow (I/I) violations must be corrected before I can receive any

   reimbursement from the Village for the work subject to this agreement.
   
   

   8. After completion of the work, I agree to submit copies of this agreement, the approved building permit,

   inspector’s approval, and contractor’s invoice (or invoice for materials) to the Public Works

   Department for reimbursement within 90 days of completion of work.
   
   

   9. I will continue to be responsible for maintenance of the driveway, stairwell, or other area drain upon

   completion of this work.
6. I/WE HAVE READ THIS AGREEMENT AND UNDERSTAND THE TERMS AND CONDITIONS CONTAINED HEREIN.
8. First Name*
9. Last Name*
11. First Name
12. Last Name
14. Address1*
16. Address2
18. City*
19. State*
20. Zip*
22. Phone No.*
23. Date*
    Date
25. Signature
27. **By typing in your name, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.**
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29. 1. Receive an email copy of this form.
30. Email address

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