HomeMy WebLinkAboutB13-0217 REV1 TRANSMITTAL Department of Community Development
0 75 South Frontage Road
TOWN OF VAIL 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$11 a will be charged upon reissuance of the permit.
Application/Permit#(s)information applies
to: Attention: Revisions
()Response to Correction Letter
O_attached copy of correction letter
/� r] Q Deferred Submittal
0 Other
Project Street Address:
-2271 h: "k
(Number) (Street) (Suite#)
Building/Complex Name: ��� A/��/ (0J Description of Transmittal/List f Changes, Items Attached: .
Applicant Information
I
(architect,contractor,owner/owner's reps —
Contact Name: (/
Address: &1 �
City State: clO zip: VY 31
Contact Name: (use additional sheet if necessary)
Contact Phone: T� ��/ Building Permits:
7_ Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: /d T/A2 (DO NOT include original valuation) ��yy �,�y�
I hereby acknowledge that I have read this application,filled out Building: $ �V (/�/+�
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 /� ,,ry
ordinances and state laws, and to build this structure according Electrical: $ '24
`� y
to the town's zoning and subdivision codes, design review ap-
proved,International Building and Residential Codes and other Mechanical: $
ordinances of a Town app�thereto. O OR/
X Total: $
Owner/ ner's R esent ive ignature(Required)
aIG3- 14 S _ - Date Received:
For Office Use Only:
Fee Paid: D
Received From: JUN 55 2013
Cash Check# ,
CC: Visa/MC Last 4 CC# exp.date: !'J� (� .LA
Authorization# TOWN OF VAIL