HomeMy WebLinkAboutB13-0146 TRANSMITTAL, FOUNDATION ILC Department of Community Development
0 75 South Frontage Road
TOWN OF VAIL 1 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
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
(� ( ) Deferred Submittal
Other
Project Street Address:
—
&J r_ CP_- c�QIC- l�j
czy
(Number) (Street) (Suite#)
Building/Complex Name:_ �t�1L i 'Z.>� Description of Transmittal/List of Changes, Items Attached:
Applicant_Information
(architect, contractor,owner/owner's rep)
Contact Name: 6: k_'z_' L IU-
Address:
City J.-ID I,.JA Q ,Q S State: C—O Zip: �(p3
Contact Name: l,ki?,ti 111L_t-,-,
(use additional sheet if necessary)
Contact Phone: q-?6) �����
Building Permits:
J t .Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail Z` N L-l_ CEO (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 Buildi and Residential Codes and other Mechanical: $
ordinances o the ble thereto.
X Total: $
Owner/Owner's Represe ative Signature(Required)
Date Received:
p [E (� E � ME
For Office Use Only: 2 2 2013
Fee Paid: OCT�J
Received From:
Cash Check# TOWN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization#
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