HomeMy WebLinkAboutB12-0274 TRANSMITTAL FOR RET. WALL REVISION 05302013 f <;;:. Department of Community Development
(( 75 South Frontage Road
Vail,CO 81657
TOWN OF l/A:IL 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.
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Application/Permit#(s)information applies
to: Attention: &Tfeevisions
�S I�0� 7 , / ^LQ�' O Response toPy of Letter
�--I! ,K attached co of correction letter
Deferred Submittal
((0 Other
Project Street�ress:
(Number) (Street) -1 (Suite#)
/
Building/Complex Name: /J) Description of Transmittal/List of Changes, Items Attached:
ppsp 'nETR/IBC/�U T'�
Applicant Information
(architect,contractor,ownerlownner's rep)
Contact Name:� —
C!Cy T 1 ugjj 1{_SE�0
Address: �D 1717 X 13,R g
City F State:C_Zip: g1�31
Contact Name: (use additional sheet if necessary)
Contact Phone: Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: (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: $
ordinances of the Town applicable thereto. Total: $D
OwnedOwner's Representative Signature(Required) ---------------------------------------------------------------—--------------------------------------------
—" -
Date Received: [E ^ /7 E
' v
D
MAY 3 0 2013
� For Office Use Only:
Fee Paid:
Received From:
Cash Check# TOWN OF VAIL
CC: Visa/ MC Last 4 CC# exp.date:
Authorization#
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