HomeMy WebLinkAboutB12-0531 transmittal Department of Community Development
75 South Frontage Road
TOWN OF VAII � �' r va�i, 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
���_� /� ''��S c�. I O attached copy of cto�ection letter
��� � � _�/^�� ( j Deferred Submittal
�U Other
Project Street Address:
,(Number) (Street) (Suite#) -
' Building/Complex Name: �� V1�6a�.�'� �r� � '; Description of Transmittal/List of Changes, Items Attached: '
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_ ' _ _ �L � .�.. C►��T.�� r,���-r�-� I�l,.�.�.T��c�
Applicant Information �A ` ,
�.�.!'�.��viLk�i
(architect,contractor,owner/owner's rep)
'Contact Name:��V�'� l�����/lr✓��G�
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Address: �� ' ��G,�.(���i �_
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City��iA���� State: C�Zip: �16.5� ''
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, �Id this structure according ',Electrical: $ '
to the town's zoning a subdivision odes, ign review ap-
' proved,Int rnationa uilding and eside ' odes and other Mechanical: $ '
ordi an e f T a pli reto. '
!Total: $ '
O nedOwner's Repre ntative uired) -t- ----^~------�- - '
� � �i t�� j ��V� � -
' Date Recei
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,IUN a 5 1U��
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For Oflice Use Only:
i TOWN QF VAIL
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Auth#