HomeMy WebLinkAboutB12-0247 Transmittal Department of Community Development
75 South Frontage Road
TOWN OF VAIL �f va�i, co s�ss�
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: Q Revisions
612-0247 Martin Haeberle �Response to Correction Letter
�attached copy of correction letter
Q Deferred Submittal
/P'1 Qther Framing ILC and Foundation ILC
�l
Project Street Address:
5194 Main Gore Drive, S
(Number) (Street) (Suite#)
BuildinglComplex Name: Description of Transmittal/List of Changes, Items Attached:
Framing Improvement Location Report and Foundation
Applicant Information
Improvement Location Report
(architect,contractor,owner/owner's rep)
Contact Name: Brian Reske
Address: PO Box 6184
City Vail State: CO Z�p: 81657
Contact Name: Brian Reske
(use additional sheet if necessary)
Contact Phone: 317-374-6700
Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: (DO NOT include original valuation)
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: $
Xrdinance�he Town applic�thereto.
�^ �__�` Total: $�
Owner/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#