HomeMy WebLinkAboutB13-0387 REV1 TRANSMITTAL.pdf Department of Community Development
0 75 South Frontage Road
TOWN OF 1/A1t � Vail, CO 81657
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
d°fee of$110 will be charged upon reissuance of the permit.
Application/Permit#(s) information applies
to: Attention: Revisions
) Response to Correction Letter
_attached copy of correction letter
74,I S DDefeerred Submittal
O
Project Street Address:
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant,Information
(architect, contractor, ownerlowner's rep)
Contact Name' +� - 1 l VI
Address 4 Q4 1
r.r) < r,.
City I / State: Zip:
Contact Name:'` (use additional sheet if necessary)
Contact Phone: � Building Permits:
,�, Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail:y�t y\ I k4wk .M(gLL6 do I ° ct A(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: $
ordinances oft Town applicable thereto.
X t Total: $
Owner/Owner'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 #