HomeMy WebLinkAboutB13-0282 CR1 transmittal Department of Community Development
, 75 South Frontage Road
TQWN OF VAIL � --' � Teivsio a��s Z�Zs
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
ta; I � � ttention: ( )Revisions
( ) Response to Correction Letter
attached copy of correction�etter
��� ,�� /; I r„�(J` ( ) Deferred Submittal
�, �� ��J ( )Other
Project Street ddress:
� ��'O��.S" ccts+r �r�t' �
(Number) (Street) (Suite#)
Building/Complex Name: � � • � S� `� ' Description of Transmittal/List of Changes, Items Attached:
Applicant Information : � ,
�r. Svar� �n.�f�, f c� I—
(architect,contractor,owner/owner's rep) i
�/� , 'pLu�� S
'Contact Name�� P'n��^
Add ress: P.� �c� ►c ���—
Clty �6xWr+
�f State: ��� Zip: �(� ��
'ContaCt Name: ���� � N�''�� �,(use additional sheet if necessary) '
� . _. . , ., : . , ,,.
Contact Phone: �)U' " �S v '' S` �' Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: n���s �c't'w�vi r r� � . ��f (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, I
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 I
ordinances and state laws, and to build this structure according I Electrical: $
to the town's zoning and subdivision codes, design review ap-
' proved,International Building and Residential Codes and other 'Mechanical: $
ordinances of the Town applicable thereto. I
'X ��'`��`._=--__ I,Total: $
,Owner/Owner's Representative Signature(Required) - - -- - ---- - -- -
Date Received:
� � IS �I �/ �
For Otfice Use Only: �
Fee Paid: E�q�� 1 � ��13
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: �I"1,�A/Ai f'�� +�'+��� �
1,.J Y Y�'N l.A
Auth# r,x.............._____ _.