HomeMy WebLinkAboutB12-0484 REV2 AND REV3 TRANSMITTALDepartment of Community Development
75 South Frontage Road
TOWN 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
(z —oLi ?ter Rc�a
Project Street Address:
(Number) (Street) (Suite #)
Building /Complex Name:
Applicant Information
(architect, contractor, owner /owner's rep)
Contact Name: fn ; G 1_ �O
Address: _PD I nle 7,5--,92—
City �A- a..p.S State: 60 Zip: 4ye-
�tevisions
0 Response to Correction Letter
_attached copy of correction letter
() Deferred Submittal
(0 Other
Description of Transmittal/ List of Changes, Items Attached:
� /i.%L �•✓cr. y �---•C /�G iYr - ....emu
\ ���� L
Contact Name: Cti�i S! � � i i� (use additional sheet if necessary)
Contact Phone: Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
Contact E -Mail: %ZGvn/, % (ip i401- - C Oft (DO NOT include original valuation)
I hereby acknowledge that I have read this application, filled out Building: $ 700d
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 L oA
ordinances and state laws, and to build this structure according Electrical: $7 _
to the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Mechanical: $
ordinances of applica le ther 00
X `, Total: $ B-% yZ00
Own r /Owner's Representative Signature (Required) ------------- ----------------- ----------------------------------- ------------------------- ---- -------- --- ---- --- -- - - - - --
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check #
CC: Visa / MC Last 4 CC # exp. date:
Authorization #
Dt5 V IS U V IS
JAN 10 2013
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