HomeMy WebLinkAboutB13-0217 REV3 transmittal � " �"� Department of Community Development
. / 75 South Frontage Road
TOWN OF VAIL � Te� 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.
ApplicationlPermit#(s)information applies
ta; Attention: �Revisions
�� � �� � Q� � � ( ) Response to Correction Letter
attached copy of correction letter
�o_ r � �^�,� � I_G;r�� ( j Deferred Submittal
�� `1� `C. Other
Project Street Addre�s:
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(Number) (Street) � (Suite#)
Building/Complex Name:�� �� �^� T�1►��`�'/ '. Description of Transmittal/List of Changes, Items Attached:
. � ��F.� �- � �� -
Applicant_Information + �f ��— � '
'� S ..
(architect, contractor,owner/owner's rep) ' `
,�.�--. ^ ", +� '�J4 ✓ t�1/�e /' / �
Contact Name: �/'' � �(/S�� �� �
,.f�'��-v 1' /�v _" � < r
Address: 1l "� '
City State:�Zip: �� �
Contact Name: ,n'1 � (use additional sheet if necessary)
Contact Phone: Building Permits:
Revised ADDITIONAL Valuations (Labor& Materials)
Contact E-Mail: (DO NOT include original valuation)
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I hereby acknowledge that 1 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 a Plumbing: $ ���
comply with the information and plot plan,to comply with all Town '
ordinances and state laws, and to build this structure according '; Electricaf: $
' to the town's zoning and subdivision codes, design review ap-
proved, Intemat�nal Building esidential Codes and other Mechanical: $ '
ordinances e Town i tF�ereto. ���
x ' ""� Total: $ � .
;
Owner/O ner's Re ive Signature(Required)
Date Received:
� � � � �/ l�
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For Office Use Only: ��1� l. 1 2013
Fee Paid: � ` �� (�0
Received From:
casn Check# TOW N O F VAI L
CC: Visa/MC Last 4 CC# exp.date:
Authorization#