HomeMy WebLinkAboutB13-0012 REV1 TRANSMITTAL Department of Community Development
0 75 South Frontage Road
TOWN OF
IVAI ` 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: Attenti n: ( )Revisions
_B c�a i ( )Response to Correction Letter
1 Q 1 AEU _attached copy of correction letter
( )Deferred Submittal
(%Other
Proj t Street e4,14
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,town/er/ownerr'ss rep)
Contact Name: e-1 h ` moo L
Address:
City State: Zip:
Contact Name: (use additional sheet if necessary)
:
Contact Phone: Building Permits
rJ ( z � Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: C J (DO NOT include original valuation)
`r
I hereby acknowledge that I ham read t is application,filled out 'Building: $
in full the information required,comple d 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
X i 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:
Auth#