Revised 12/30/2014
PERMIT NO. ______ ___________
VILLAGE OF WHEELING
COMMUNITY DEVELOPMENT DEPARTMENT
APPLICATION FOR CONSTRUCTION PERMIT
The undersigned _____________________________________________________ hereby applies to the Engineering Division of the Village of
(PRINT NAME)
Wheeling, IL for a permit herein described, and if granted the work will comply with all Village requirements and ordinances relating thereto including
the payment of fees required by such ordinances.
This permit is to be used for the purpose of ___________________________________________________________________________________________ at
(
SCOPE OF PROJECT)
ADDRESS:____________________________________________ Wheeling, IL Concrete Asphalt Brick Pavers
Property Owner:_________________________________Address:________________________________Phone:___________________
Parkway Restoration Bond: $_________ Check/Bond No. __________ Submitted by: ____________________________
The items are more fully set forth in the plans subm itted with this application, the estimate of the cost of the work contem plated includes underground
utilities, surface improvements and other construction work necessary to complete the project in accordance with the approved plans dated___________.
ESTIMATED COST OF PROJECT: $_______________________
CONTRACTORS:
Concrete Contractor_________________________________ Address ____________________________________ Phone _______________________
Paving Contractor (asphalt)__________________________ Address ____________________________________ Phone _______________________
Landscaper (brick pavers) ___________________________ Address ____________________________________ Phone ______________________ _
Excavating Contractor______________________________ Address ____________________________________ Phone _______________________
Testing Laboratory_________________________________ Address ____________________________________ Phone _______________________
General Contractor ________________________________ Address ____________________________________ Phone _______________________
Plumbing Contractor _______________________________ Address ____________________________________ Phone _______________________
Sewer Contractor__________________________________ Address ____________________________________ Phone _______________________
Water Contractor __________________________________ Address ____________________________________ Phone _______________________
Project Engineer___________________________________ Address ____________________________________ Phone_______________________
Environmental Services_____________________________ Address ____________________________________ Phone _______________________
No error or omission in either the plans or application, whether said plans or application has been approved by the Village or not shall permit or relieve
the applicant from constructing the work in an y other manner th an that provided for in the ord inance of this Village relating thereto. The applicant
acknowledges, by signature on this docume nt, responsibility for restoration of any and all damage to the Village right of way and/or Village
improvements (drive apron, sidew alk, g rass/trees) arising o ut of constr uction performed under this permit. The app licant hav ing rea d this
application and fully understanding the intent thereof declares that the statements made are true to the best of their knowledge and belief.
X______________________________________
Construction Fee ……………………………3.5% BUP $_____________________ Signature of Owner or Agent
Erosion & Sedimentation Control Fee ……
3.5% ECF $_____________________
Engineering Plan Review, Construction &
PERMIT AUTHORIZED BY:
Inspection Fee………………………….……
3.5% EIF $_____________________
Residential Driveway, Patio ___________________________________ _____________
and / or Sidewalk Fee……..…………...................
DRP $_____________________ Authorized Signature Date
Sewer Connection Fee…………………………… SEC $_____________________
Water Connection Fee …………………………… CON $_____________________
Miscellaneous …………………………………… $_____________________
TOTAL AMOUNT DUE. . . . . . . . . . . . . . . . . . . . . . $___________________
24 HOUR NOTICE IS REQUIRED ON ALL INSPECTIONS—PERMIT VALID FOR SIX MONTHS FROM DATE OF ISSUE
