HomeMy WebLinkAboutB13-0049 REV1 TRANSMITTAL.pdf Department of Community Development
75 South Frontage Road
TOWN OF UAIL�
0 Vail, co s1s57
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: Attention: Revisions
&ru.�ctra V14", �, 0 Response to y of corn Letter
' attached co of correction letter
Deferred Submittal
`7 Other
Project Street Address:
5g� iu,e r-�g
(Number) (Street) �n - q(S/uiten#)
Building/Complex Name: /Y L� 1,5 - � Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep) —7
Contact Name: daii, � I
Address: ?7q-7 DVV a-i
City Th_v� State: Zip: g 0 a. /
Contact Name: (use additional sheet if necessary)
p� — t
Contact Phone: �gco Building Permits:
�,1 ` Gbrn�k, Revised ADDITIONAL Valuations Labor&Materials
Contact E-Mail: I'I� ��l9Yl Gf PfCS C (DO NOT include original valuation) )
Yl�-
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.
X - 1`1�(a Total: $0
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:
Authorization#