HomeMy WebLinkAboutB13-0217 REV2 transmittal .� � Department of Community Development
75 South Frontage Road
TQWN OF VAIL � `�' ° Tel: 970.4079.2128
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: (�'j Revisions
R v / � _ 1 � � O Response to Correction Letter
�C attached copy of correction letter
--' � ���cr ( ) Deferred Submittal
�� � � �� �� -' (J 'C�� ( ) Other
Project Street Ad ress: `
,� ��I /� .�r�s�r r
(Number) (Street) (Suite#)
Building/Complex Name:��/1IA�ilr �/C�✓'��7// Description of Transmittal/List of Changes, Items Attached:
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Applicant lnformation "'� �
Qf
(architect, contractor, ownerlowner's rep)
Contact Name: � " �G �� �� �
Address: - � �D �
�ity '��/�C" �—State: �l! Zip: r� ( "
__4� / "
Contact Name: � ��,C�?C/� (use additional sheet if necessary)
.. -�� �>- ' . _ , , .. . . .... . __.
Contact Phone: � �� � Tl'7 � G' 1S � Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: (DO NOT include original valuation) �
I hereby acknowledge that I have read this application,filled out Building: .� $ l v���
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 j
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: $ '
ordinanc the Tow ' ab there
X :� Total: �
Owner/ wner' epresentativ Signature(Required)
Date Received: ���
� C� � [� � �`!1 �
�u� 2 0 �o��
For Office Use Only:
Fee Paid: l`QWN QF VAIL
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization #