HomeMy WebLinkAboutB13-0192 REV1 transmittal Department of Community Development
75 South Frontage Road
TOWN OF' VAIC� vai�, 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 '
to: Attention: �Revisions
625 Forest Road �Response to Correction Letter
�attached copy of correction letter
�Deferred Submittal
`; �t'/r���-1-� �I?l'� - �- I�1 `,3� (0 Other
'Project Street Address: �i
��, �J _�O 1''�`=�� �G�C�{ �� ��
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
;Applicant Information ' �������� �Z,7���
'(architect,contractor,owner/owner's rep) - ` � ����
��G �%TT' �. TU��/L i��S�=��'j, ���;-� -� ���iL .
'Contact Name: �li�—r�(�. I��� �.S ..�« /�r��_ `�{�u�� '
`Address: /l`=�3 �"�i/-��r�/ ;S1��f� ;5��7� ;`�!/
City ��<;��-�i State: LL Zip: �����/
Contact Name: ��L�%i�:3 /�J� vi.S (use additional sheet if necessary)
'Contact Phone: G% % d ' ��-�%'� � ��j� Building Permits:
- Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-MaiL ���ti���-=—��'�:s"�fzc ic�� G�1,-�-� (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: $ i
ordinances of the Town applicable thereto. '�
X�� - _i,v-C�� r- Total: �0
�_ �-z—r_��- -��
Owner/Owner's Representative Signature(Required)
Date Received:
Tor Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#