HomeMy WebLinkAboutB13-0117 REV1 STAMPED PLANS PAGE AND TRANSMITTAL F_'" Department of Community Development
75 South Frontage Road
t Vail,CO 81657
TOM Or VRIL:'. 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: C)Revisions
C)Response to Correction Letter
_attached copy of correction letter
O Deferred Submittal
(Other
F ddress:51#V b treet) (Suite#)
Building/Complex Name: C'� Description of Transmittal/List of Changes, Items Atfached:
Applicant Information
(architect,contractor,owner/owner's rep)2 p
Contact Name: /6[ t o f eA, /l
Address: 30,V
City State:Ci d
V t%//�.
Contact Name: �10 �� f� (use additional sheet if necessary) -- l
------------
Contact Phone: '3 / Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: pN- /L�� 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' iWaubdivision codes, design review ap-
proved, r ati and Residential Codes and other Mechanical:ordin a able thereto.
Total: $
Ow e�/Owner's epresentative Signature(Required) --------------- "- -"" -
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Date Received: �/J (�
L� 11 l"I
D
For Ofa!Um,On1Y. MAY 2013
Fee Paid:
Received From:
Cash Check#
M. Visa/ n�c Last a cC# exp.date: TOWN OF VA I L
Authorization#
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