HomeMy WebLinkAboutB12-0285 ILC TRANSMITTAL Department of Community Development
75 South Frontage Road
7OIN11 OF I/AIL '` Vail, CO 81657
Tel: 970.479.2128
www.vailgov-corn
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.
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Application/Permit#(s)information applies
to: Attention: Revisions
n l Response to Correction Letter
❑_attached copy of correction letter
nn G 0 Deferred Submittal
Other 'rt' L
Proj tt Strfet Addres ZI-J
-- x `VJ�
(Number) (Street) (Suite#)
Building/Complex Name: PLZA K Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name:
Address: II
City State: Zip:
Contact Name: (use additional sheet if necessary) J
--------------------------------
Contact Phone: 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: $
ordinances of the Town applicable thereto.
Total: $
X
Owner/Owner's Representative Signature(Required) ----------------- --------------------------------------------- -------------------------------
Date Received:
C keg 0 W
D
For Office Use Only: 1'1a 0M 2014
Fee Paid: IJ
Received From:
Cash Check# ��vp IL
CC: Visa/MC Last 4 CC# exp.date: W�1� /1
Authorization#