HomeMy WebLinkAboutB12-0297 REV 1� `
Department of Community Development
75 South Frontage Road
TOWN OF VAIL ` ,�� va�i, co s�ss�
�� Tel: 970-479-2128
www.vailgov.com
Development Revlew Coordinator
TRANSMITTAL FORM
Use this form when submitting additional information for planning applications or building permits.
This form is also used for requesting a revision to buiiding permits. A two hour minimum building review
fee of $110 will be charged upon reissuance of the permit.
_ _
Application/Pertnit #(s) information applies
to: Attention: (Dg.Revisions
n ��_ D�� � O Response to Correction Letter
r� attached copy of correction letter
[� ( ) Deferred Submittal
� `�'�'� � �. " ���— ( ) Other
_. __ __ _ _
. __
Project Street Address:
��� D r � ��
(Number) (Street) (Suite #)
Building/Complex Name: � Or�v�,�t v�. /� ��►C�c�3�Description of TransmittaU List of Changes, Items Attached:
_ �PC� i�Ll (J,d�
Applicant Information �
(architect, contractor, owner/owner's rep) �— �� ����� a���
l�r3 C� �k�,-'���� l � °.
Contact Name: K., � .
Address: �f� �_aL7�C � � 7 I � �j �
City /�t 1> O� State: � Zip: � l�d '' W� v–L.il'�S 0 t.l.�'^S 1�
Contact Name: 1,� n�/'� � P , 1� �� '(use additional sheet if necessary)
Contact Phone: ��'1 � ���_�� 7 i Building Permits:
�j C( ��T ���Q M 1� � evised ADDITIONAL Valuations (Labor 8 Materials)
Contact E-Mail: l� (ia ST �DO NOT include original valuation)
I hereby acknowledge that I have read this application, filled out
in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap-
proved, Inter tional Building and Residential Codes and other
ordinance the Town applic ble ereto.
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Owner/Owner's Repres nt e Signa r(Required)
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/
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For Oflice Use Only:
Fee Paid:
Received From:
Cash Check # _
CC: Visa / MC Last 4 CC #
Auth #
exp. date:
Building:
Plumbing:
Electrical:
Mechanical:
Total:
' Date Received:
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$
$
$ .� a-S°�_ _
$
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