SCOPE OF WORK, PART 3 Job Type: ________________________________________________________________
Estimated Cost: $________________________________ (specifically for this portion of the scope of work)
Type of Contractor: ____None/DIY ____Gen ____ Roof ____ Siding ____ HVAC ____Plumbing ____Electrical
Business Name: __________________________________________________________________________
Address, City, Zip: ____________________________________________________________
Cell Phone: __________________________ Email: _________________________________
SCOPE OF WORK, PART 4 Job Type: ________________________________________________________________
Estimated Cost: $________________________________ (specifically for this portion of the scope of work)
Type of Contractor: ____ None/DIY ____ Gen ____ Roof ____ Siding ___ HVAC____ Plumbing ____ Electrical
Business Name: __________________________________________________________________________
Address, City, Zip: ____________________________________________________________
Cell Phone: __________________________ Email: _________________________________
TOTAL ESTIMATED PROJECT COST: $______________________________________
IMPORTANT NOTIFICATIONS FOR OWNER & APPLICANT
1. Contractor Registration Required: Complete information on ALL contractors is required prior to permit approval.
The Village will verify that all contractors are currently registered with VRLB (see our website for requirements).
2. Attention Owners with HOAs: The Village will evaluate this application based on compliance with the Village’s
codes and ordinances. It is the Property Owner’s responsibility to verify the proposed improvements meet the
guidelines of your local homeowner’s association.
3. Owner’s Representative Legal Statement: By signing below, the Applicant hereby certifies that all information
provided herein is true and correct; that all provisions of the ordinances of VRLB shall be complied with; that the
proposed work is authorized by the owner of record; and that I have been authorized to submit this application as
his or her agent.
Signature of Homeowner: _____________________________________________ Date: ____________________
Signature of Contractor: _______________________________________________ Date: ____________________
Return with ALL REQUIRED ATTACHMENTS to the Village Hall or by email. Your application will be processed within 10
days.
FOR OFFICE USE ONLY
Approved by Director of Inspections: _____________________________________________________ ______________
Signature Date
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
