HomeMy WebLinkAboutB12-0510 REV2 TRANSMITTALDepartment of Community Development
� 75 5outh Frontage Road
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�-���i� �� ���� :=:'' Vail, CO 81657
Te I : 970.479.2128
www.vailgov.com
Development Revisw 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.
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ApplicationlPermit #(s) information applies
to: Attention: �evisions
� �� r� `/ i % esponse to Correction Letter
J L/ �_attached copy of co�rection letter
� Deferred Submittal
���� {� Other
Project Street Address:
(Number) (Street)
Building/Complex Name:
Applicant Information
(architect, contractor, ovmer/owner's rep)
Contact Name:
Address:
City
Contact Name:
Contact Phone:
Contact E-Mail:
State: Zip:
(Suite #)
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 esidential Codes and other
ordinanc f the To applicabl tFj�r�to.
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Owner/Own s epresentative Signature (Required)
For Office U� Only:
� ��a:
Received From:
Cash Chedc #
G�C: V sa / MC Last 4 G� # exp. date:
authorization #
Description of Transmittal/ List of Changes, Items Attached:
/ G G �Z
� . �'
(use additional sheet if necessary)
Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation)
Building:
Plumbing:
Electrical:
Mechanical:
To�i:
Date Received:
$_
$
$
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NQV � 2 2012
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TOWN OF VAIL