HomeMy WebLinkAboutB13-0170 TRANSMITTAL 052013.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAI L 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: O Revisions
Response to Correction Letter
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Lattached copy of correction letter
O Deferred Submittal
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Other i4dd4 1 f)a r f+G.v-/
Project Street Address:
S Z lyfC-,6J ()f i;v �
(Number) (Street)
(Suite#)
Building/Complex Name:_ �(���� S,cAc� Description of Transmittal/List of Changes, Items Attached.
Applicant Information
(architect, contractor,ownerlownner's rep) ,{
Contact Name:
Address:, �<�_D SG>r.41�, (i
City c State:L �Zip:
Contact Name: ' �`��"' 1 n e ~ (use additional sheet if necessary)
Contact Phone: O Gf �1 Building Permits:
Labor&Materials
Contact E-Mail Revised ADDITIONAL Valuations� ���` � M�� 4.�("� ( )
(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 build this structure according Electrical: $
to the town's zoning and sub ivi on codes, design review ap-
proved,International Building a d Residential Codes and other Mechanical: $
ordinances of the Town t cable thereto.
X Total: $
Owner/Owner's Repres ntative Signature(Required)
Date Received:
For Office Use Only:
Fee'Paid:
Received From:
Cash Check #
CC: Visa/MC Last 4 CC# exp.date:
Authorization #