S.A.P. No.
SITE ALTERATION PERMIT
VILLAGE OF WHEELING
The undersigned does hereby apply to the Engineering Division of the Village of Wheeling, Illinois for a
Site Alteration Permit to allow the movement of earth as herein described. The undersigned agrees to
comply with all the requirements of Wheeling's Erosion and Sedimentation Control Ordinance (Title 20 of
the Wheeling Municipal Code).
Signature Date
Name
Title
Address
City/State/Zip Phone
Site location and description:
Proposed development:
When submitted by the applicant, this form shall be accompanied by all information required by Title 20
of the Wheeling Municipal Code.
Permit fee $
V
ILLAGE APPROVA
L
Plan review fee $
Date
Inpection fee $
Total ECF $
Signature
Issuance of this permit does not exempt
the applicant from obtaining all other permits
or approvals required by the Wheeling
Name
Municipal Code, State or Federal laws.
Surety Amount
$
Title
(Revised 1/19/10)