HomeMy WebLinkAboutB13-0170 REV CR1 TRANSMITTAL Department of Community Development
75 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/Perm it#(s)information applies
to: Attention: O Revisions
aResponse to Correction Letter
(11r vi'd attached copy of correction letter
1 t Q Deferred Submittal t
o ) 1 0t✓l� 1 C-2 1 Otherf�l.•t) TiL. I
Ncs t.3 - c-)"z ol
Pro ct Street Address:
Lj }v )4,tL),J s J:l✓, *: —Z,,
(Number) (Street) j (Suite#)
BuildinglComplex Name: (. � r .``7 Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name: OrIL L r -�'-
Address: // �U jr v <� "�� Cj
City 7-G,� State: O Zip: It
Contact Name: �+ Lcr�� Iv (use additional sheet if necessary)
Contact Phone: _i ) �� Building Permits:
Contact E Mail:
��U ��;^ f Revised ADDITIONAL Valuations (Labor& Materials)
�MGc4 f t (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 uffding and Residential Codes and other Mechanical: $
ordinances of the T n applicable thereto. 0
X Total: $
Owner/Owner's R presentative Signature(Required)
Date Received:
For Office l se Onlc
Fee Paid:
Received From:
Cash Check r, RECEIVED
CC: Visa/MC Last 4 CC# exp. date:
Authorization # By David Rhoades at 11:17 am, May 29, 2013