HomeMy WebLinkAboutB13-0528 CR1 transmittal Department of Community Development
75 South Frontage Road
'���/� �.� '����� 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
4 to� Attention: � evisions
� �Response to Correction Letter
� -�— ��L2�-x �attached coNy of correction letter
( �Deferred Submittal
� f�Other
_... _
�Project Street Address: €
��1.� "�(�l��P.iJ � �
�(Number) (Street) (Suite#) _._..._�. ..... .. ......._
1;.....,,,�.,_,,.._._._.._...,._�_.,...._.........._.�...�...........,..,,....._____.�_._._..____�_
� p
f Building/Complex Name: ` Description of Transmittal/List of Changes, Items Attached:
� �
�,�..__............ti._��,.w.r.., ._.._....__......d..ws___.......__............... � �..._M.�_�. � At�l7►'�iG�JAL ',51�(C�?S '
!Applicant Information
�
(architect,contractor,owner/owner's rep) '
/� .n �f �-- �
`i Contact Name: /�tLL 1''Iw1ERi�r4.� 1'1�14?t� �C. �
!Address: L�,� ��1LPOiC'f �. � � ?
:City�'��CKFJJRIDC'yE State:�Zip:_���� �
;Contact Name: �,Aw� ���tEtL �
�(use additional sheet if necessary)
C��� � ��____�_ � . � _ n � _ , __
;Contact Phone: �(Y `' 1'"t OD �Building Permits:
���n ,/�� ^ �� � �Revised ADDITIONAL Valuations(Labor 8 Materials)
Contact E-Mail: l� fi t•a� GtL►'"�ys(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 Building and Residential Codes and other ;Mechanical: $
'; ordinances Town pplicable thereto. ;
�( �Total: $�
�O ner/O sentative Signature(Required) �--- � --- — ---- �-- — --� --��
__._. __._.__.._ _ — -_____ ______ __,___ ._. '�; Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization #