HomeMy WebLinkAboutB13-0016 REV1 TRANSMITTAL �---�-�:�
(�� Department of Comrnunity Development
_ t���� 75 5outh Fronfage Road
I Dt��fa� {��= VA���' va�i,C� 81657
Tei: 97D_4792128
www_vailgov.com
Development Review Coordinator
TRANSM 1TTAL F�RNI
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: evisions
1 / 2 ,. � r / v� � � �Response to Correction Letter
� � �O �_aitached copy of correction letter
. �Deferred Submittal
(,�Other
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Project Street Address:
�
��� �aL�_S7�hc�✓ch �J+'. /V'4k .`�' !
(Number) (Street) (Suite#}
BufldinglComplex Name: Description of Transmittal/List of Changes, Items Attached: �
S�r���--�L- � ���s �
Applicant Information --�—.
�`— � � Q�,v�, �
(architect,contractor,ownerlowner's rep) �
Contact Name: � � �`'9'��''�c" r l.7DOY ,p,A��p r���
�Ct r L G.4.S f'D�vl 1 c,�����C/'
Address:��J. J�D 1� 2-Q'7 P' � , - L��l/�L�� !"ODN�. dCw� S)'r+s�
Cif Uc� /���� '
Y�� /�5�, State: C m Z�p; SC����-
` d6 D lt 3
Contact Name: G �' h �N ��"H•(.C„t{�L (use additional sheet if necessary) �
5�70 -.9�Qcf -O S� l Z. ---=-----__.__=:=-r_.-:______-=-----__----__---=--__=_--_--_-_=-_-===-1
Contact Phone: Building PermiEs:
� ,,c,. Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail:��h i d�h ��c�t.L �[.cSt�JM � �'o� �(DO NOT incfude original valuation)
I hereby acknowledge that I have�ead this application,filled out Building: $ �
in full the information required,completed an axurate plot plan,
and state thatall 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 rz .
� Total: $0
Owne�/Owner's Representat`i e Signature(Required) --------- ------------------------------------------------------------------ -----------------
Date Received:
� I.G, \`J � IJ �J I'�,—
ForOfficeUseOnly: App oO Z01�
Fee Paid:
nr R �
Received From� ,� ���� ��
�� Check# i '����J pF VAIL
CC: �/sa/ MC Last 4 OC# exp.date:
Authori�tion#