HomeMy WebLinkAboutB13-0049 REV2 transmittal Department of Community pevelopment
75 South Frontage Road
TOWN OF VAIt � vai�,co s�ss�
Tel: 970.479.2128
www.va i Igov.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.
ApplicationlPerrnit#(s)information applies �--�
to: ��� -- C; D �f-C� Attention: �Revisions � �
�������L L f,�G�U'I.C� f ;n Gi-/'�i i� , '�u��,�� �Response to Correction Letter
� 4. attached copy of correcUon letter
� ', / �" `� Q Deferred Submittal
� C'U/1 Q./LC..�' �c..(� C` Ct�y�l� Y �/"� p Other
Project Street Address: �
�5 ✓�-� � - � �_ F- l �' ! �� � J ���5
(Number) (Street) / (Suite#)
Building/Complex Name: �'��<-'ll.tL%L � �%�t-�� l�.����� Description of Transmittal/List of Changes, Items Attached:
n
% ' '�' G�LC..�t G�l6Yt �i� ,�� ,�,
Applicant Information
� `' �
�C.-e G� � l C�`t'"! �t G
(architect,contractor,ownerlowner's�ep) ,, /� � ,y �� I^ :�
;/}��.L �L%G Zt�c-� �.. �-� L�.`"C.�.x� �;�'l,t,i'�Cx 1f� �I"I�C-�....� �
Contact Name: � 1
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Address: � ' -
City h-�t-'Yl C.- �r�-�-�- State: �-�U Zip: �C'/�-
ContaCt Name: �^�7��1 (use additional sheet if necessary)
Contact Phone: 3�%> - � � �•% -� ��� `1 Building Permits:
� � Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-MaiC I_ �'�f'.-V�l G'"Y'!C-�f K S C:� C��`�1'I L^Gi�S f (DO NOT include original valuation)
I !C�'i Y.
I hereay 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,Intemational Building and Residential Codes and other Mechanical: $ '
ordi an s of the Town applicable thereto.
X �L-M' P ! �`� �? �.C..L�,I _'.�, Total: $0
Owner/Owner's Representative Signature(Required)
Date Received:
For Office lisc Only: � �
Fee Paid: ! i �� ,/` (1 i7 (�
Received From: � `, -- �'� � � ��1 �C,
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Cash Check# !"t+
CC: Visa!MC Last 4 CC# exp.date: ��,�,! APR 2� 2013
Authorization# � I�
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1`OVi/N OF VAIL