HomeMy WebLinkAboutB14-0012 CR1 transmittal �a�`'�'`'':<<, Departrnent o#Community Developm�nt
,� 75 South Frontage Road
T�DWN OF VA�t.�� vai�,�o s�s5r
Te I: 970.479.2128
www.�ailgov.com
Development Review G�ordinator
TRANSMITTAL FO�'f�M
Use this forrn when submi#ting additional information far planning applicatians ar b�ilding permits.
This form is also used for requesting a revision to building permits. A two haur minimum building review
fee of$110 will be charged upon reissuance of the permit.
ApplicationlPermit#(s)ir�formation applies
to: Attention: (� Re�isions
Lianshead Parkin Enf Mr. Martir� Haeberle t�Response ta Correction Letfer
9 rY �attached copy of correction letter
(]Deferred Submittal
�(]Other
Project Street A�ldress:
350 South Frontage Road
(Number) [Streety (5uite#)
BuiEdinglGomplex Hame: �-�onshead Parking Str�aCture Descriptior�of Transrsiittal/Liat of Changes, Items Attached:
-Ramoved "Not for ConstruGtion" rsote an Ci�il Drawings
Applicant fnformation
-Stamped and signed unstamped {Landscape}drawings
(architect,contractor,ownerlowner's rep)
Co�ntact Name: Zehren and Asso�eiates
Address: PO Box �976
City �`von Stata: �� Zip: 81620
Contact Name: Thomas R bu Bois
(use additianal sheet if necessary)
Contact Phone: `�70-94$-D257
Building �ermits:
tomd zehren.com Revised ADDITIONAL Valuations(Labor 8� MateriaEs)
Cpntac# E-Mai{: @ (DO NQT incfude original�aluation)
I hereby acknowledge that I have read this application,fiiled out Building: $Q
in full the information required,�cornpleted an accurate plot plan,
and sta#e that a�l the information as required is correct. I agree ko plumbing: $�
comply witl�the information and plot plan,to compzy with all Tawn
ordinances and state laws, and#a build th�s structure according E4ectrical: $�
to the town's zaning and subdivision codes, design review ap-
proved, International Building and Res�dential Codes and other Mechanical: $�
ordinances ofth�wn appiicable thereto.
+ Total: $�
!
OwnerlOwner's Representafive Signat�re(aequired)
Date Received:
For Office Use Only:
Fee Paid:
Received Frcam:
Cash Chec4c#
CC: Visa/MC Last 4 CC# exp.date:
Authorization #