HomeMy WebLinkAboutB13-0516 CR1 transmittal Department of Community Development
75 South Frontage Road
TOWN OF VAtL� vai�, co 8�s57
Tei: 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.
_
ApplicatioMPermit#(s) information applies
to: Attention: ( ) Rev' ' s
n� �� � C'� ��� ( esponse to Correction Letter
,�> J attached copy of correction letter
() n,�. I � _��� � ( ) Deferred Submittal
t' �� ( ) Other
Project Street Address: � � ;
�— K-�r�N l�-(yv� t C� ,� � �
(Number) (Street) (Suite#)
Building/Complex Name:��-�•J r�yJ 11� `���/' ' Description of Transmittal/List of Changes, Items Attached:
��v� �
Applicant_Information
(architect, contractor, owner/owner's rep)
Contact Name: ���) �'1 Y ,����'
Address:
City State: Zip:
ContaCt Name: (use additional sheet if necessary)
Contact Phone: Building Permits:
Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: (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: $
ordinances of the Town appl'cable thereto. ��
X �� ���-_l_� Total: $
Owner/Owner's Repres �ive Signature(Required)
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/ -�`",.,
G%/ Date Received:
D � � � ° M �
For Office Use Only:
Fee Paid: MAR 1 � ZQ,�.
Received From:
Cash Check# �..�wN �� VA I�
CC: Visa/MC Last 4 CC# exp.date:
Authorization #