HomeMy WebLinkAboutB13-0192 CR1 TRANSMITTAL.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAII '
0 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$110 will be charged upon reissuance of the permit
Applica-tion/Permit#(s) information applies
to: Attention: Revisions
O Response to Correction Letter
3 - 019 [3Ld�• 1��,�7' 0_attached copy of correction letter
O Deferred Submittal
Other
Project Street Address:
Z S _ro,eE'5r AoA
(Number) (Street) {Suite#�
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
� ice- ser of llexrnrr
Applicant Information Ccvlse6 n
a�//7lY G Hr9NG S
(architect, contractor, ownerlowner's rep) ScrB4,21771 9-4,
Contact Name: _5C07r 721,-r
7-o .d2r�wrn.�S ,�dcr n✓�'D
Address: P. O. SOX .3 3 8$ BY Fi r�G flyV(� �[JIC�b�NU
City e1q&6Z�' State: Ceg. zip: BAG
Contact Name: (use additional sheet if necessary)
Contact Phone: 970- %o 5/-- Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: .5G01AG .55 7�97/46. C-OM (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 t tlild this structure according Electrical: $
to the town's zoning and subdivi on codes, design review ap-
proved, Inte I Building an Residential Codes and other Mechanical: $
ordinan s of th own applicabl thereto.
X Total: $
Owner/Owner's Representative Signature(Required)
D via .yr,�voul Fa,C scam iu�N�pSC���
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization #