HomeMy WebLinkAboutB13-0265 CR1 transmittal Department of Community Development
� , 75 South Frontage Road
TOWN OF Vaf L�� �� va�i,co a�ss7
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Tel: 970-479-2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Use this form when submitting additional information for planning applications or buiiding permits.
This form is also used for requesting a revision to buiiding permits. A two hour minimum building review
fee of$110 will be charged upon reissuance of the permit.
ApplicationlPermit#(s)information applies .
to: �A tion: ( )Revisions
l�f2esponse to Correction Letter
attached copy of correction letter
����_ ��' � ( )Deferred Submittal
� `_ ( )Other
Project Street Address:
,(Number) (Street) (Suite#)
Building/Complex Name:(i i`�o�Sl�LC�s.t ��� ' Description of TransmittaU List of Changes, Items Attached:
Applicant information
� ,
� ��- ��=�u�z 7��L- ��� c��' '���7"� �Lr4��
(architect,contractor,owner/owner's rep)
'Contact Name: ( /��t 1 ���^� ���
Address:
'City State: Zip:
Contact Name: �t7' ` � G✓l')7�� �.., (rif,[rr �(use additional sheet if necessary)
Gv3 z 38 7�7 � ,,. . � ., , . . ;.
Contact Phone; Building Permits:
� , ��.�� `� / Revised ADDITIONAL Valuations(Labor&Materials) '
Contact E-Mail: � � L'1� L t�J'7'v�'l • C G� ',(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 I 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- I
' proved,International Building and Residential Codes and other ',Mechanical: $ '
ordinances of the Town applicable thereto. I
X �Total: $ �
Owner/Owner's Representative Signature(Required) --- - -- -- -
' ' Date Received:
For Office Use Only: D ���� ��'//�'
Fee Paid: �" �
Received From: ��� 1 '� ����
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
n�tn# �WN OF Vq�L