HomeMy WebLinkAboutB12-0382 REV3 TRANSMITTAL AND RECEIPT. :
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�__i� Department of Comrnunity Development
� 75 South Frontage Road
Vail, CO 81657
Tel: 970.479.2128
www_vailgov_com
Development Review Coordinator
TRANSMiTTAL F�R1V!
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(Permif #(s) information applies
to:
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Attention: � Revisions
� � Response to Correction Letter
�_attached copy of correction letter
� Deferred Submittal
(,� Other
Project Sireet Address:
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(Number) (Street) (Suite #)
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BuildinglComplex Name: �'�� Wy� �,
flpplicant Information
(architect, contractor, ownerlowner's rep)
Contact Name: �� �1 �.l.V�v�
Address:
City State: Zip:
Contact Name:
Contact Phone: /�` � ��� y ����
Contact E-Mail:
I here6y acknowledge that I have read this applicaiion, filfed 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 Residential Codes and other
ordinances of the Town applicable thereto.
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Owner/Owner's Representative Signature (Required)
For Office Use Only:
Fee Paid:
Received From:
Czsh
CC: Uisa / MC Last 4 CC #
Authori�tion #
Check #
exp. date:
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Description f Transmittal/ List of Changes, Items Atfached:
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(use additional sheet if necessary)
-----------------
Buitding Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
(DO NOT include original valuation}
Building: $
Plumbing: $
Electrical: $
Mechanical: $
Total:
Date Received:
$0
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TOWN OF VAIL, COLORADO Statement
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Statement Number: R130000130 Amount: $110.00 03/O1/201310:06 AM
Payment Method:Credit Crd Init: DR
Notation: MC DENNIS
(R.A. NELSON)
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Permit No: B12-0382 Type: COMBINATION BLDG PERMIT
Parcel No: 2101-081-0000-2
Site Address: 841 VAIL VALLEY DR VAIL
Location: GERALD R. FORD AMPHITHEATER @ FORD PARK
Total Fees: $7,853.02
This Payment: $110.00 Total ALL Pmts: $7,853.02
Balance: $0.00
******�******+*************�**�**�*****�************+�*�****+***r*****�****�**********�*****
ACCOUNT ITEM LIST:
Account Code
--------------------
PF 00100003112300
Description Current Pmts
------------------------------ ------------
PLAN CHECK FEES 110.00
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