HomeMy WebLinkAboutB13-0424 REV1 TRANSMITTAL 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 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: Wevisions
Rc✓ ' ( ) Response to Correction Letter
` 'L,P Q _attached copy of correction letter
( ) Deferred Submittal
50 O Other
Pro'ect Street ddress.
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Chiang s, Items Attached:
L�
Applicant Information
S'
(architect, contractor, owner/owner's rep) ,
Contact
Name-0
Address: �X
City S State: C�ip: ( o
Contact Name: I, iv vv ryJ (use additional sheet if necessary)
Contact Phone: Building Permits:
Revised ADDITIONAL Valuations (Labor& Materials)
Contact E-Mail: S y (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 tow ' ing and subdiJsion codes, design review ap-
proved, terna on Buildin nd Residential Codes and other Mechanical: $
ordinan e he w i abl eto.
X Total: $
Owner/Owner's Representative Signature(Required)
Date Received:
D M [E
For Office Use Only: OCT 2 4 2013
Fee Paid: li
Received From:
Cash Check# TOWN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization #