HomeMy WebLinkAboutB13-0490 REV1 transmittal i
Department of Community Development
75 South Frontage Road ',
���� �� ���� � Vail, CO 81657 ,
Te1: 970.479.2128
www.vailgov.com '
Development Review Coordinator ,
TRANSMITTAL FORM
Use this form when submitting additional information for planning applications or building permits. I
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. j
. .._...__ ._ � . ........... ._..... . ....... . . . ...._ . . . ._...... ...__. ....__._ .� . . ........ � . ._..._ .__._ ,
Application/Permit #(s) information applies '��
to: Attention: � Revisions �
� 300 �2„ � Response to Correction Letter �
� R Q _ ,a,attached copy of correction letter �
� Deferred Submittai ..
� Other
............. _._. ........ ..
Project Street ddr s • ',
$ �re �� _. On . '
(Number) (Street) (Suite #) _.w_ ____.___ � _.... __.
Buildin /Complex Name: � � �� B � S "'°/� p q � De�rl tion of Transmittal/ List of Chan es, Items Attached: � ,
9 p 9
W�
Applicant Information � _ . � �
. (architect, contractor, �owner/owner's re )� � ! ;
fl C� C�ti�..fNa '
� Contact Name: � E
Address: q � � W � '
City State: �.A Zip: 84� 2� d �
�i ContaCt Name: . g (use adddionai sheet rfnecessary)
3 v3 � 73 Fl — S �o y �. ._ —_.— �. .,..��..�..w.�.�,sm—�> _= _.—,., .,„.,�...� '
Contact Phone: Bu�ldmg Permits �..
, � _ __„ „ Q� � ! � I�., CO � Revised ADDITIONAL Valuations (Labor & Materials) ! �
Contact E-MaiL � Kn � � 0.�C It) (DO NOT include original valuation) j �
�—' �
I hereby acknowledge thatl have read this application, filled out Building: $ J � ,
; in full the information required, completed an accurate plot plan, ` i
' and state that all the information as required is correct. I agree to plumbing: $ T �
I compty with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according Electrical: $ E �
to the town's zoning and subdivision codes, design review ap- _ ;
proved, International Building and Residential Codes and other Mechanical: $ ` ,
ordinances of the Town applicable thereto. �
X �,�,, pnnti.2 Total: $ � ;
�
, '
'� Owner ner's Representative Sign re (Required) -,-- ,---�---.-�---�-----___..._ _. . . ....... . . .____._,_._._.._._,.___.._..__.., ���.
� � . Date Received:
�
..__�__._._ _._ ._._.__ _, . . . �.......... . . . . ....___._. . . .._._.. . ._. �.
i
:
Ror OfScc Use Only:
Fee Paid:
Received From: �,
` Cash Check # �
CC; Visa / MC Last 4 CC # exp. date: �
� Authorization # �