HomeMy WebLinkAboutOTC13-0008 REV1 TRANSMITTAL 0 Department of Community Development, ? 75 South Frontage Road
TOWN OF VAIL 1 Vail, CO 81657
100 000, 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: ( ) Revisions
to /G / 3-ap62 Response to Correction Letter
_attached copy of correction letter
P• 13-� � �C ( )
Deferred Submittal
Other
Project Street Address:
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant Information l ,Q
(architect, contractor,owner/owner's rep)
Contact Name: X;11; ems/
Address:
City ��1�/G'Ca /L✓ State: ��Zirx !9 8-5
Contact Name: (use additional sheet if necessary)
Contact Phone: `7 `� � Building Permits:
C�� ,, Q�, Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: 0' /il ( °C (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: $
ordinances of th Town applicable thereto.
X Total: $
Owner/Own is Represen ative Signature(Required)
Date Received:
For Office Use Only: JUL J 2013
Fee Paid:
Received From:
Cash Check# TOWN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization #