HomeMy WebLinkAboutDRB130027 ILC transmittal � Department of Community Development
75 South Frontage Road
TOWN OF VA(�. � vai�, co a�ss�
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 ;.s cf��rged upon reissuance�f!he permit.
Application/Permit#(s)information applies
to: Attention: ( ) Revisions
� �_j _ �a� ( ) Response to Correction Letter
� attached copy of correction letter
•' 9nnG ( ) Deferred Submittal
.nR�l 3�oa 7 ���3"'�1���/ �L�C�CK�.-� ( ) Other
Project Street Address:
�a ����f I`�[��,�J��.� 1��. �k �g
(Number) (Street) (Suite#)
Building/Complex Name: '�-� f t���r t �-t/?V! 1���!7i.'-�. Description of Transmittal/List of Changes, Items Attached:
�
_ �� l ��
Applicant_Information
(architect, contractor, owner/owner's rep)
� r�
Contact Name: l./�� 'I L't V!��� �C_�C�'C�'� K.��
Address: f—O �ox !� c��(
City��n/n, r��� State: C� Zip: b�� ��
r;
Contact Name: ^ Cil 1^ � (S Y�V1C>�C��''v'� E^� (use additional sheet if necessary)
Contact Phone: n'(7 � �7 C/S �U �� Building Permits: _ _ ..
Contact E-Mail: (�C`i� � I i� � 1 r ��(n i �1 e C,p�v. Revised ADDITIONAL Valuations(Labor& Materials)
'f I (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 y p�umbing: $
` 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 the Town applicable thereto.
X ,:;, Total: $
Owner/Owner's Representa ignature(Required)
Date Received:
� � � � MI�
For Office Use Only: D �1
Fee Paid: S�I� `�Zu��
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: TOWN �F VAIL
Authorization# �