HomeMy WebLinkAboutB13-0048 REV1 TRANSMITTAL.pdf Department of Community Development
kr 76 South Frontage Road
TOWN OF VAIL 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: Attention: 10 Revisions
0 Response to Correction Letter
JZattached copy of correction letter
Deferred Submittal
0 Other
Project Street Address:
Of I- C Va.i &499:! L r-3
(Number) (Street) (Suite#)
Building/Complex Name: L4A9t /ate yDG
Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep)
1 CL[ �'Ll �D GC�YYI
Contact Name: 5
Address: _s 7`C 7 5yV a_t-
City State: W Zi 0 d 2
'Contact Name: (use additional sheet if necessary)
Contact Phone: 3tz S 81P—1 q0`'J Building Permits:
� o Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: / l BY /U f? S�.GQ�iy/CC( (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 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: $
ordinan es of the To ap licable thereto.
X ,Q�tt, X�/ ��,{,(� � 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#