HomeMy WebLinkAboutB13-0542 CR1 transmittal Department of Community Development
� ,� 75 South Frontage Road
TOWN OF VAIl. � vai�, co s�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.
ApplicationlPermit#(s) information applies
to: Attention: ( ) Revisions
��, �,�'S�� � ��-/)`1 �� ` J . ( ) Response to Correction Letter
.{_� �_l� �"r attached copy of correction letter
( 1��� � �__�s`76 ( ) Deferred Submittal
( )Other
Project Street Address:
1 0��v d'•1 .t��`�f'4C� /�a� �
(Number) (Street) (Suite#)
Building/Complex Name: l ( ���`-���� Description of Transmittal/List of Changes, Items Attached:
Applicant,lnformation �G��yv�� �� ������ �
� ��coU �o jl�L�,� ��l��S rtiA7c� H�'i�
(architect, contractor, owner/owner's rep) ,�r �,,� Q � n
Contact Name:-�'►��.-�� CJ� ��'rC� �J�U�� ���� /��5����L�L y C�7�il�� l'����
Address: � (6�) d_��l !�6r �IU
City �G���r State: � Zip:�
Contact Name: �t�,i��� lT►►��(`j�" (use additional sheet if necessary)
Contact Phone: �76 —g�6— ����
Building Permits:
Contact E-MaiL y-�-U'I�--� ���k��-'` US _ Revised ADDITtONAL Valuations (Labor& Materials)
(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, Inte national Building a e ' ial Codes and other Mechanical: $
ordi�nf the Town t to.
X •� ' Total: $
Owner/0 ner's r entative Signature(Required)
�
Date Received:
� � � Q �/ �
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For Office Use Only: ��A� o � �1�`�(�
Fee Paid: �,�
Received From:
Cash Check# TOV11I� OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization #