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HomeMy WebLinkAboutB13-0126 REV1 CR1 TRANSMITTAL Department of Community Development
75 South Frontage Road
TOWN OF VAIl. '
0 Vail, co s1s57
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
v ( ) Response to Correction Letter
fin 2 l-t 1 _attached copy of correction letter
15,5 P�l �. I ( Otherre� ubmitt IW,4it C� 1
Project Street Address:
(Number) (Street) (Suite#)
Building/Complex Name: wl �� Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep) #
Contact Name: 6M
:Address: ;bv
s
1
City Stta/te: U Zip. 7
Contact Name: (use additional sheet if necessary)
Contact Phone: Building Permits:
C o5 1 C�Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: (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 B ' Ing and Residential Codes and other Mechanical: $
ordinances of the applicable thereto.
X Total: $
Owner/Owner's RLIpresentative Signature(Required)
Date Received:
D
For Office Use Only: 0 2013
Fee Paid: OCT t�t J
Received From:
Cash Check# TOWN OF VA I L
CC: Visa/MC Last 4 CC# exp.date:
Authorization#