HomeMy WebLinkAboutB13-0009 CR1 TRANSMITTALDepartment of Community Development
0 75 South Frontage Road
TOWN OF VAIL' 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 z
to: 1 _0opq 0-P Attention: �evisions
1 •
a 1� es onse to Correction Letter
attached copy OT COTMTttOn etter
( O Deferred Submittal
c��coTT �lrtn SC�QnCQ P��i3'���LO 0Other
Project Street Address:
�sLl
(Number) (Street) J (Suite #)
Building /Complex Name:
Applicant Information
(architect, contractor, owner /owner's rep`)
Contact Name: /��r�
VV
Address: Lo 04) A 1 h4 m
City on State: Co Zip:
Contact Name: I ' t is ! r— -1,)rC_
Contact Phone: ,y�� 7(>— �o l6-) (3
Contact E -Mail: II lk(Z - i-ir`��4Ce,��m
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. l 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 Residential Codes and other
or ynance7 the T wn @pplicable Jhjareto.
Owner /Owner's Representative Signature (R6'quired)
For Office Use Only:
Fee Paid:
Received From: _
Cash
Check #
CC: visa / MC Last 4 CC # exp. date:
Authorization #
/Description of Transmittal/ List of Changes, Items Attached:
(use additional sheet if necessary)
Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation)
Building:
Plumbing:
Electrical:
Mechanical:
Tota I:
Date Received:
;:
$0
RECEIVED
By David Rhoades at 12:11 pm, Jan 28, 2013