HomeMy WebLinkAboutDRB130153 REV1 TRANSMITTAL.pdf Department of Community Development
OT 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/Permit#(s) information applies
to: Attention: Revisions
Response to Correction Letter
1896 West Gore Creek Drive Conceptual DRB application Warren Campbell attached copy of correction letter
C)Deferred Submittal
Revised drawings REV1 (C)Other
Project Street Address:
1896 West Gore Creek Drive
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Conceptual DRB submission application drawings
Applicant Information
for a new single family residence
(architect, contractor, owner/owner's rep)
Survey w/vicinity map, site plan,floors plans, elevations,
Contact Name: Michael Pukas
Address:
PO Box 288 model views, and building sections
City Gypsum State: CO Zip: 81637
Contact Name: Michael Pukas
(use additional sheet if necessary)
Contact Phone: 970-390-4931
Building Permits:
nsho com m desi Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: michael @ pp g p' (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.
X Michael Pukas Total: $0
Owner/Owner's Representative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/ MC Last 4 CC# exp. date:
Authorization #