HomeMy WebLinkAboutDRB130173 REV1 TRANSMITTAL �..' Department of Community Development
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` 75 South Frontage Road
Vail,CO 81657
91411IV a VA. I,., .. 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: bpio Attention: O Revisions
f 30 I—7
C)Response to Correction Letter
_attached copy of correction letter i
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Deferred Submittal
Other
Project Street Ad ress:
,In6
T
(Number) (Street) (Suite#/)
Building/Complex Name:_ / Description of Transmittal/List of Changes, Items Atfached:
Z `
Applicant Information
(architect,contralctoro,-o'wn'eriowner's rep)
Contact Name:
Address:/(Z=[
City State: (1-1/�) —Zip:
I
Contact Name: (use additional sheet if necessary)
Contact Phone: T Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: /�V AIr /� �� (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: $
ordinanc f the Town livable thereto.
X /. Total: $D
0 net/Owner's Representative Signature(Required) ------------------------------------------—--------
Date Received:
j CCU [E DYC
For Office Use Only: D
Fee Paid: JUN 1. 1 2013
Received From:
Cash Check# C 1/!(,SAS
CC: Visa/ MC Last 4 CC# exp.date: TOWN OF VAI L
Authorization#