HomeMy WebLinkAboutB13-0393 CR1 TRANSMITTAL.pdf Department of Community Development
75 South Frontage Road
TOWN UA f L Vail, CO 81 657
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 be charged upon reissuance of the permit.
ApplicationlPermit#(s)information applies
to: Attention: O Revisions
3 Response to Correction Letter
attached copy of correction letter
C)Deferred Submittal
O Other
Project Street Address: ff
-E �` - Lt
(Number) (Street) ll }} � �(Suite#)
BuildinglComplex Name: + t K !6 Description of Transmittal/List of Changes, Items Attached:
Applicant Information 481ee I or-� 1 61t 0
(architect, contractor,ownerlowner's rep)Contact Name:_-r
Address: f �1• 6 Ok
City Avr;?r✓t State: �} zip: N
Contact Name: 7 L1 C117f�+^ (use additional sheet if necessary)
Contact Phone: f - y7 Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: lC!�a 6 AS(&265 (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 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-
proved, International Building and Residential Codes and other Mechanical: $
ordinange,s of a Town applicable thereto.
Total: $0
X
Owne wner's Representative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#