**LETTER OF INTENT IS REQUIRED**
DATE: _________________
PROPERTY ADDRESS: _________________________________________________RIVER GROVE, IL 60171
PROPERTY OWNERS NAME: _________________________________________ PHONE: __________________
PROPERTY OWNERS EMAIL: ___________________________________________________________________
CONTRACTOR NAME: ______________________________________________ PHONE: ___________________
CONTRACTOR ADDRESS: _____________________________________________________________________
STATE LICENSE # ______________________ COST OF INSTALLATION OR REPAIR: $_______________________
PLUMBING FEES
Number of Fixtures ________ @ $20.00 EA.
Fixtures include bathtub, lavatory, water closet, shower, laundry tub, kitchen sink, dishwasher, bar sink, washing machine,
water fountain, floor drain, faucets etc.
Minimum Inspection Fee: $60.00
WATER TAP: _______ SIZE: _________ METER COSTS: __________ SIZE: _________
DESCRIPTION OF WORK: ______________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
PERMIT APPROVED BY: _____________________________________ DATE: __________________________
PLUMBING PERMIT APPLICATION
VILLAGE OF RIVER GROVE
2621 THATCHER AVE, RIVER GROVE IL 60171
DAVID B. GUERIN, PRESIDENT
PHONE 708-453-8007 FAX 708-453-1337
PERMIT NUMBER ____________________
DATE ISSUED ____/_____/_____________
APPROVED FEE $____________________