HomeMy WebLinkAboutB12-0382 transmittal Department of Community Development
75 South Frontage Road
���� �� ��j� 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
B12-0382 M. Haeberle �Response to Correction Letter
�attached copy of correction letter
�Deferred Submittal
�Other
Project Street Address:
841 Vail Valley Dr. Vail
(Number) (Street) (Suite#)
Building/Complex Name: G.R. Ford Amphitheater Description of Transmittal/List of Changes, Items Attached:
Letter of compliance from third party testing agency
Applicant Information
(architect, contractor, owner/owner's rep)
Contact Name: RA Nelson Mike Kowalski
Address: 51 Eagle Dr. #2
City Avon State: CO Zip: 81620
Contact Name: Mike Kowalski
(use additional sheet if necessary)
Contact Phone: 9�0-445-0351
Building Permits:
mkowalski ranelson.com 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.
X Mike Kowalski rotai: $°
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 #