HomeMy WebLinkAboutB13-0128 REV1 TRANSMITTAL Department of Community Development
0 75 South Frontage Road
TOWN OF VAIL Vail, CO 81667
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
0 Response to Correction Letter
I I b JZattached copy of correction letter
Q Deferred Submittal
Other
Project Street Address: iQ1
3cl Z
(Number) (Street) (Suite#)
Building/Complex Name:[ 1 l (�1 U l �2� Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name:
Address:
City\J Lit c State:��zip:
Contact Name: (use additional sheet if necessary)
AContact Phone: V! D -5 Building Permits:
Contact E Mail: t Uti��C��C![/LG 01 �ti1S�.�'c l Revised ADDITIONAL Valuations(Labor&Materials)
(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,I ati 1 Building and Residential Codes and other Mechanical: $
ordinan Town applicable thereto.
X ( Total:
Owner/Owner's Representative Signature(Required)
Date Received:
For Office Use Only. D Nrl�l r'L
Fee Paid: qq�
Received From: MAY 0 2b 13
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization# L TOWN OF VA I L