HomeMy WebLinkAboutB11-0412 B11-0351 TRANSMITTAL FOR SPECIAL INSPECTIONS 112213 Department of Community Development
0 75 South Frontage Road
TOWN OF VAII. ' 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
O Response to Correction Letter
U
1J Q 3 5 �+L ( f�eo�°r _attached copy of correction letter
( ) Deferred Submittal
( ) Other
Project Street Address:
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant Information
�(1 0 Z 26)
(architect, contractor, owner/owner's rep) ,/
Contact Name: �� �;i►^ >�r`'�
Address: 4
v C7
City �966 _Sta Zip:
Contact Name: (/ (use additional sheet if necessary)
Contact Phone: �70 -331 S--D Building Permits:
/ Revised ADDITIONAL Valuations (Labor& Materials)
Contact E-Mail:��'�-mSvn ��/ ,fit/ (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 plot plan,to comply with all Town
ordinances and state law , and o build this structure according Electrical: $
to the town's zoning a subdi ' n codes, design review ap-
proved, International uildin Residential Codes and other Mechanical.
ordinances of the T wn a hereto.
X Total: $
Owner/Owner's Representative Signature (Required)
Date Received: �n
V
D
For Office Use Only: NOV � 2 2f UU 71/�'
Fee Paid: N V
Received From:
Cash Check# TOWN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization #