HomeMy WebLinkAboutB12-0274 REV1 transmittal . .
- i"'ti,
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' -- Department of Community Development
- �� �`" 75 South Frontage Road
TOWN OF VA(L� vai�, co a�s5�
Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Use this form when submitting additional information for pianning 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 rE°ssuance of the permit.
Application/Permit#(s)information applies
to: Attention: Q Revisions
. � ,,, - r ! �Response to Correction Letter
r� ': � � �` f � �attached copy of correction letter
- � Q Deferred Submittal
.�.�� +� _ r J i C,-,_� fQ Other
b
Pro'ect Street Address: � � } '
��� �t��L�� �6�.
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(Number) (Street) �Suite#)
Building/Complex Name: ������� L�� ; Description of Transmittal/List of Changes, Items Attached:
Applicant Information � 1 „ , ��_
�—_ ��v
(architect,contractor,owner�6wner's rep) ^��� � � ,�j
� � v�� � � �'Y� `/`����i'�'�
Contact Name:�,��' C� _ ��j ^ �
f '��/ v `
Add ress: `--�
City_ Stat�_Zip:
Contact Name: I l��f"� ��i'V �l,L"� °:(use additional sheet if necessary)
Contact Phone: � ���`� Building Permits:
•�� `'� r-y�--`��CC���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 an�other 'Mechanical: $
ordinances of ow a ica efeta '
�X -- / ,/1-����� �Total: $� ,
Owner/Owner's tat e Signat &�quired �
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i�
Date Received:
� � � Q �
For Oflice Use Only: D
Fee Paid: ,�
Received From: >lUN 0 � 2013
Cash Check# � ''.��
CC: Visa/MC Last 4 CC# exp.date: �'1,/►i I� �/A t
Authorization# - - ��✓V�►N o f- V/`1I L