HomeMy WebLinkAboutB12-0189 REV3 TRANSMITTAL.pdf Department of Community Development
75 South Frontage Road
rQ ��
61 a Vail, CO 81657
Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Revision Submittals:
1. "Field Set"of approved plans MUST accompany revisions.
2. No further inspections will be performed until the revisions are approved &the permit is re-issued.
3. Fees for reviewing revisions are$55.00 per hour(2 hour minimum), and are due upon issuance.
Permit#(s) information applies to: Attention: ' Revisions
B12-0189 Haeberle Response to Correction Letter
_attached copy of correction letter
Deferred Submittal
Other
Project Street Address:
1416 Moraine Drive
(Number) (Street) (Suite#)
Building/Complex Name: Description/List of Changes:
1. Modify Fireplace
Contractor Information
Business Name: Gillette LLC
Business Address: Post Office Box 5821
City Vail State: CO Zip: 81658
Contact Name: Brian Gillette
Contact Phone: 970.390.7981
(use additional sheet if necessary)
Contact E-Mail: brian_gillette @gillettellc.con Revised ADDITIONAL Valuations (Labor&Materials)
(DO NOT include original valuation)
I hereby acknowledge that I have read this application,filled out
in full the information required,completed an accurate plot plan, Building: $
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 Plumbing: $
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap- Electrical: $
proved, International Building and Residential Codes and other
ordinances of the Town applicable thereto. Mechanical: $
X ;st Owner' s Representative 0
Owner/Owner's Representative Signature (Required) Total: $
Applicant Information
Applicant Name: Job Hernandez Date Received:
Applicant Phone: 970.333.2097
Applicant E-Mail: jobhernandezmn @prodigy.net.mx
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Auth#
01-Oct-11