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HomeMy WebLinkAboutB12-0565 transmittalDepartment of Community Development 75 South Frontage Road �-��� �� ,����� �� Vail, CO 81657 Te I: 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. _._.. _. - - - ApplicationlPermit #(s) information applies to: Attention: � Revisions ��t'� � d�� G � Response to Correction Letter � J ❑_attached copy of correction letter � � Deferr d Submittal ' ��,v � � ' fl �''Jcri� �� Other�4,M[�1)� '��,�� QIi� �j l' ; - - --- - _ _- -- 3 Project Street Address: �fr2, 7�.�'�1,� Ck—�� (Number) (Street) (Suite #) Building/Complex Name: �� �N V` L� Applicant Information ', (architect, contractor, owner/owner's rep) '�, Contact Nam���Q��I`Ok� f� I Address�� � � f 1 i City�� StateG� Zip: �r ', Contact Name: �DYI � - � � Contact Phone: �� d �� � ��' � ��, Contact E-Mail:����� e� 111�,.[��b�%'D . C O1(� i � �I 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- I prov Intern 'onal Building and Residential Codes and other ' r i n s of th Town applicable thereto. ' Owner/O r's Representative Si ature (Required) I. _ _ s_ � s._ _r.__ _,__._._ _ .._ _ ---4. _� -----_. . ._...... e -. _.._..._. For OfficeUseOnly: Fee Paid: Received From: Cash CC: �lsa / MC Last 4 CC # Authorization # Check # exp. date: Description of Transmittal/ List of Changes, Items Attached: Re,�m��. �4� 7s,a� Lfl�1�sc-���, �Q�ne�d�l Q��o.c FR��r� �e�^m;fi i'� �,'�'�c ; (use additional sheet if necessary) Building Permits: Revised ADDITIONAL Valuations (Labor & Materials) (DO NOT include original valuation) Building: Plumbing: ' Electrical: � Mechanical: , Total: $_ $_ $_ $ $0 _ . .. -- -_ _ __ -. - Date Received: � � � � � � D oCT 3 i 2o�z �I'��ORM � TOWN (�F VAIL