HomeMy WebLinkAboutB13-0459 REV1 Department of Community Development
� 75 South Frontage Road
TQWN OF VAIl. ' / va�i, co $�ss7
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
� �j�3 �N attached copy of correction letter
( ) Deferred Submittal
����3— a �� � ( ) Other
Project Street Address:
�`�r�21.�bc� S`�".
(Number) (Street) (Suite#)
BuildingfComplex Name: Description of Transmittal/List of Changes, Items Attached:
. �'RAVI�Ll��r'.�NS �[ P'E
Applicant lnformation
(architect, contractor,owner/owner's rep) `C�������- ��2 �/S��C�
Contact Name: C A�N Sr (Yt t TG}�}�t L "��m � �'
Address:�� X Z�iO '
City W(�`� State:�6 Zip: �
Contact Name:
(use additional sheet if necessary)
Contact Phone:��n 3� 7z�� Building Permits: :
Revised ADDITIONAL Valuations (Labor 8�Materials)
Contact E-Mail:S��N��alr/�/Yl�7�,/�ELl (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 '
ordina s and state laws, and to build this structure according `Electrical: $
' to the t n's zoning and subdivision codes, design review ap-
prove 1 erna ion Building and Residential Codes and other Mechanical: $
ordin e t e n applicable thereto.
X Total: $
Owne n Representative Signature (Required)
Date Received:
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p � � � oM �
For Office Use Only.
Fee Paid: ��a� 1 � ����
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: TQWI� QF ��AIL
Authorization #