HomeMy WebLinkAboutB12-0301 - CR1 - 092812 TRANSMITTALrnwH OF van
Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970 -479 -2128
www.vailgov.com
Development Review 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 building permits. A two hour minimum building review
fee of $110 will be charged upon reissuance of the permit.
Application /Permit #(s) information applies
to: Attention: 4Re ' ions
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Project Street Address:
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( esponse to Correction Letter
_attached copy of correction letter
( ) Deferred Submittal
( ) Other
(Number) (Street) (Suite #)
Building /Complex Name: N arit, Description of Transmittal/ List of Changes, Items Attached:
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Applicant Information )
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(architect, contractor, owner /Iownees rep)
Contact Name: j
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Address:
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Contact Name: �`' f kC
(use additional sheet if necessary)
Contact Phone: Building Permits:
f Revised ADDITIONAL Valuations (Labor & Materials)
Contact E -Mail: rJ Cco C��^� C�3�( �/Vr7 (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, International Building and Residential Codes and other
ordinances of o n a licable thereto.
X I/
Owner /Owner's Repres tative Signature (Required)
For Office Use Only:
Fee Paid:
Received From:
Cash Check # _
CC: Visa / MC Last 4 CC #
Auth #
exp. date:
Building: $ 3,5 60
Plumbing: $
Electrical: $
Mechanical: $
Total: $ 3SGO, cO
Date Received:
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SEP 4 4 & 1Z
TOWN OF VAIL