HomeMy WebLinkAboutB13-0189 REV1 TRANSMITTAL Department of Community Development
� 75 South Frontage Road
TOWN OF VAIL , vau, 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 requestlng a revision to building permits. A two hour minimum building review
fee of$110 will be charged upon reissuance of the permit.
ApplicatloNPermit#(s)Informatton ap
to: A �U
Revisions
: � �� �,S D Q� 2 _ O Response to Correction Letter
Q L� J attached copy of correction letter
Deferred Submittal
'� S/B D�13" � ��D �Other
Project Street Address:
�� 1�t�E C,Q. U'I L G�
(Number) (Street) (Sulte#)
Bullding/Complex Name: Description of Transmittal/List of Changes, Items Attached:
ApPlicant Information _ �L`/5/�� S/:C�11t,_/Y/��D�P/�J.(�/A�/.�T
(archltect,contractor,ownerlowner's rep) �"���"�` v� � �—/����
Contact Name: �aUCfi�l�� /i[�.
Address:_�.�. �la
City �//�i(/ State: (� zip: 2�
ContaCt Name: �EjQ���(��L(f/�!� (use addftional sheet'rf necessary)
Contact Phone: l7b�l�—Co3y/ Building Permits:
Revised ADDITIONAL Valuations(Labor 8 Materials)
Contact E-Mail: ��i�(���'L/L//�LJ�_ _t�,�� (DO NOT Include orlginal valuatlo�)
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: $ (�j�
comply with the information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according Electrical: $ d�
to the town's zoning and subdivision codes, design review ap-
proved,Intemational Building and Residential Codes and other Mechanical: $ d �
Xrdinances e To ap�b�hereto.
lTota�: $� �, �
OwneNOwners Representative Signature(Required)
Date Received:
D � � � OM �
For Offlce Use Only: ,�UL � �O��
Fee Pald:
Received From:
casr, cr,�k# TOWN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization#