HomeMy WebLinkAboutB12-0585 REV1 TRANSMITTAL v-,<f;:.is
V�
Department of Community Development
75 South Frontage Road
TOWN OF VA all, 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: O'Revisions
L,� � 2—...r 0 ,5 ,Ac,e- 1 ae �er f e 0 Response to Correction Letter
Ji( f^[ attached copy of correction letter
Q Deferred Submittal
60ther Ne W A _Sn s�eef- em fJv"
Project Street Address:
130 q E I V__
(Number) (Street) (Suite#)
Building/Complex Name: �� f + L �! S Description of Transmittal/
]]List of Changes, Items Attached:
It�+5 �✓� 5 T� TeAmpor Cary Of `+ eS
Applicant Information y 1�
(architect,contractor,owneriowner's rep) 1
Contact Name: If 41/N_ ��a5�Af sA�� I: � c�". ,S�eehs k�,ti,52 ]-I-
Address: L, 3,50 /V, Z/ 5 Z� c) 'H
City C k6L"t It State: A Z—Zip: 2
Contact Name: (use addifional sheet if necessary)
Contact Phone: 71 -9 J— `�` 71— 3
Building Permits:
� - / � Revised ADDITIONAL Valuations(Labor&Materi I s
Contact E-Mail: C1 a � �� ,
(DO NOT include original valuation) �J
I hereby acknowledge that I have read this application,filled out Building: $
in full the information required,completed an accurate plot plan,
and state that all the information as required is correct. I agree to Plumbing: $
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according Electrical: $
to the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Mechanical: $
ordinances of the Town applic ble thereto.
Total: $Q
Owner/Owner's Representative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check# RECEIVED
CC: Visa/MC Last 4 CC# exp.date:
Authorization# By David Rhoades at 10:32 am, Nov 09, 2012