HomeMy WebLinkAboutB13-0052 REV2 TRANSMITTAL.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL ` Vail, CO 81657
Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Use this form when suhmitting additional information for planning applications or building permits.
This Farm 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: Revisions
ICJ I bJ Z 0 Response to Correction Letter
attached copy of correction letter
0 Deferred Submittal
Other
Project Street Address: 13 o q`7 Z_
2-c) 'h 1
(Number) (Street) (Suite#)
BuildinWCornplex Name: Description of Transmittal/List of Changes, Items Attached:
d �Applicant Information I,
(architect,contractor,ownerlowner's rep) ' "�)
.-
Contact Name: CF,
Address 1(j 0�!(bCc10�71
City V'k Stater,Zip
Contact Name
r _ j (rase additional sheet if necessary)
Contact Phone �� -E' r Building Permits:
Cry�, � �� Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail �,r p f (DAD NOT include original valuation) r�
hereby acknowledge that I have react this application,filled out Building: $ A Ott . UZ
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: $
ordinances of the Town applicable thereto.
A Total: $D ,an
Owner/Owner's Qprosentalive Signature(Required)
Date Received:
For Owlee Use Only:
Fee Paid:
Received From:
Csh /Clerk#
CC- Visa/MC last I CC# exp.clam?:
AuthoriUation#