HomeMy WebLinkAboutB13-0133 TRANSMITTAL.pdf Department of Community Development
0 75 South Frontage Road
TOWN OF VAIt & 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$110 will be charged upon reissuance of the permit.
Application/Permit#(s)information applies
to: Attention: O Revisions
�y pp ()Response to Correction Letter
� �kJ1 attached copy of correction letter
O Deferr�.dlS matal
1(�ther W� 14A A cab On
Project Street Address:
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached
Applicant Information — .
(architect,contractor,owne rlow n er'rt'}�s-►r,ee'p�)
Contact Name, l
Addressr V bo' 4-H 10
City U—' U LA5 State eb
.•
zlp: �6�
Contact Name: 46*7 ^��y�7V`t4(,11'L (use additional sheet if necessary)
Contact Phone: �Z �LV Building Permits:
r p, Revised ADDITIONAL Valuations(Labor$,Materials)
Contact E-Mail 1 �' 1 (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-
proveq,Yternational Building and Residential Codes and other Mechanical: $
ordm s of the T wn a plicable thereto
Total: $o
Owner! wner's Representative Signature(Required)
Date Received:
For Office t se On I)
Fee Paid:
Received From: _
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:_
Authorization#