(Confidential) In which fire district do you reside? In which fire district do you reside? Long Grove Fire Protection District Countryside Fire Protection District I Don't Know Business Name Name Address Cell Phone Email Business Owner Name Street Address City State Zip Code Cell Phone Email Property Owner Street Address City State Zip Code Cell Phone Email Property Management Company Name Street Address City State Zip Code Phone Email Key Holders Business Name Business Address Business Owner Property Owner Phone Number Key Holder Name Phone Number Key Holder Name Phone Number Key Holder Name Phone Number Burglar Alarm Monitoring Firm (if applicable) Name Phone Fire Alarm Monitoring Firm (if applicable) Per Village ordinance number 2013-0-16, fire alarm and detection systems required. Name Phone I hereby register my emergency alarm system and fire alarm system and agree that I will abide by all applicable provisions of the AlarmOrdinance of Long Grove, IL. For any questions, contact the Village of Long Grove at 847-634-9440 Electronic signature agreement:By selecting the "I Accept" button, you are signing this agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement. Date Electronic Signature Electronic Signature I accept This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. View PDF of Page
