HomeMy WebLinkAboutB12-0484 REV1 Transmittal��� ;.
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Department of Community Development
75 South Frontage Road
Vail, CO 81657
Tel: 970.479.2128
www.vailgov.com
/' � Devetopment Review Coordinator
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TRANSMITTAL FORM
Use this form when submitting additional information for planning applications or building permits.
This form is aiso 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. --- ----
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ppplicationlPermit #(s) information applies qttention: Revisions
to: � Response to Correction Letter
�_ �, L�� J �_attached copy of correction letter
t j� � ��� `�1-- � Deferred Submittal
�— 1� Other
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Project Street Address: j
1> Lr � l 111► /�S/1 � v h�,Y �C" ---
#
(Number) (Street)
BuildinglComplex Name:
qpplicant Information
(Suite )
(architect, contractor, ownerlowner's rep) � � v��
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Contact Name: �
�� Address: �� � � � ��� �
I �i��.�A�!-�7 f State: (�(j _Zip: J>CI� : Z !
�, City
A � �. 1 . ( �� �
, Contact Name: �
i Contact Phone: � %� � oZ � � ' � `'�y �,
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', Contact E-MaiL T�NL Y2 t/'�%l (�___, L� C d� —
' 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
Ito the town's zoning and subdivision codes, design review ap-
proved, International Buildingca�n�d Rheretotial Codes and other
i ordinances of th To n app'
�I Owner/Owner's Representative Si nature (Required)
For Office Use Only:
Fee Paid:
Received From:
�� Chedc #
CC: Usa / MC Last 4 CC #�— exp. date:
Authorization #
Description of Transmittal/ List of Changes, Items Attached:
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, " .�C'ry ✓!�'1
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(use additional sheet if necessary)
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Building Permits:
Revised ADDITIONAL Valuations (L.abor & Materials)
; (DO NOT include original valuation) ���
� -- ZDbd ,
; Building:
Plumbing:
Electrical:
Mechanical:
Total:
: Date Received:
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$ o .� ��o
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OCT 2 �2012
TOWN UF VAIL