HomeMy WebLinkAboutB13-0127 REV1 TRANSMITTAL Department of Community Development
75 South Frontage Road
TOWN OF VA 1 Wail, 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: ,p Revisions
/(-)—,Response to Correction Letter
V O_attached copy of correction letter
T, 0
Deferred Submittal
62 Other
Project Street Address:
�� (A/, VAUky Tv yf,
(Number) (Street) (Suite#)
Building/Complex Name:�iL � LOME- Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name: l��f
I � xs,
�
Address: TV
City State: 60 Zip:
Contact Name: �� � (use additional sheet if necessary)
Contact Phone: Building Permits:
��f frf � � � 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: $ ! J 01
in full the information required,completed an accurate plot plan, /�
and state that all the information as required is correct. I agree to Plumbing: $ 200
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,Inte4tional Building and Residential Codes and other Mechanical: $
ordinan s Town applicable thereto �7��
X Total: $0
Owner ner's Representative Signature(Required) -
Date Received:
For Office Use Only: JUN 1 2013
Fee Paid:
Received From:
Cash Check# TOWN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization#