HomeMy WebLinkAboutB13-0063 transmittal � Department of Community Development
75 South Frontage Road
TOWl� OF VAIL�� va�i,co s�s5�
Tei: 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: ( ) Revisions
`� ` 2 �� /_ ( )Response to Correction Letter
� �..� �� attached copy of correction letter
�� �� � ( )Othe�red Submittal
--.C���� - c �
Project Street Address:
(Number) (Street) (Suite#)
� �
' Building/Complex Name: � M �G � lf� ; Description of Transmittal/List of Changes, Items Attached:
Applicant Information ,
�eM � � � ' v��f�/�
(architect,contrac�owner/owner's rep) �
'Contact Name: � G C O "" � � !
�.;o� �� ► L�,P �� o�s.
Address:_r� � O G�j� ,
'City State:�� Zip: �/ �
Contact Name: J�Tl I����� ,(use additional sheet if necessary) '
�17a -- ��y -o�9S , , _ , _ . � , � . .
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 requi rrect. I agree to I Plumbing: $ '
, comply with the information and pl an,to co ply with all Town ' ��� ',
ordinances and state laws, and build this ucture according ;Electrical: $
to the town's ing a sub � ision co , design review ap-
' proved, rnational B ildi and idential Codes and other ;Mechanical: $
ordi nces of the To n I' .
' __ I Total: $
rs e :e ent iv ' equired) _ _ .
_ . _.. _ _. _ Date Received:
For Office Use Only:
pC� C� � � dC�
Fee Paid: N�u � J
Received From: f� �� ��;�
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: TOWN OF VAIL
Auth#