HomeMy WebLinkAboutB13-0217 REV5 transmittal...�..a:
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, Department of Community Development
75 South Frontage Road
-�— Vail, CO 81657
TO WN O F VA I L� Tei: s7o.a7s.2�2s
www.vailgov.com
St� /� ' Development Review Coordinator
TRANSMITTAL FORM � (� [� (� �/J (�
e this form when submitting additional information for planning applications or buildi � ermits.^ `
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This form is also used for requesting a revision to building permits. A two hour minim uil�n`g review ` �
fee of$110 will be charged upon reissuance of the permit. TQWN �F VA�L
ApplicationlPermit#(s)information applies Revisions �
to. Attention: �
( Response to Correction Letter
� � � ,. ` � -;�'j � � �-Cj'lf� � attached copy of correction letter
( ) Deferred Submittal
� � ( )Other
_ .
Project Street Address: , r . _ ,/� �
��' �-� �t n;�rr�C � ° .
(Number) (Street) (Suite#)
�`'f�� ,;`;j,�,�{`� �/r"�� 'C(,�? Description of Transmittal/List of Changes, Ite�ns Attached:
BuildinglComplex Name: i�� �
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Applicant,lnformation �t l � S/�� ���
(architect, contractor,owner/owner's rep) �� /���,J S�— /���� �S�
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Contact Name: l Y J v�'{�� ' � ` ,
Address:_.���7� �� 7 �
City State: �f� Zip: `;5�' 3�
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Contact Name: / / �7 / ��� (use additional sheet if necessary)
Contact Phone: Building Permits:
._.--- �'` ,,.� ,� J..p� � ��� Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: � � / � �W � ��` 'G "`°"' (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 `a 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 Bui�ding anc�.S�sidential Codes and other Mechanical: �
ordinances of th��fown a CECable t reto:�" �
X � Total:
Owner/Owne 's Repre ntative Signature(Required)
Date Received:
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For Office Use Only: �Fl.� ll q L.o�3
Fee Paid:
Received From:
Cash Check# "r'�WN �F vA�L
CC: Visa/MC Last 4 CC# exp.date:
Authorization #