HomeMy WebLinkAboutB14-0059 CR1 �... _ _
� Department of Community Development
75 South Frontage Road
TOWN OF VAIl. � / �f va�i, co s�ss�
� 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 wili be charged upon reissuance of the permit.
Application/Permit#(s) information applies
to: Attention: ( ) Rev' ions
�I ' L `G��C� �n � esponse to Correction Letter
`"� < <�� attached copy of correction letter
�' '/ ���� ( ) Deferred Submittal
�-!' ( ) Other
Project Street Address:
��—`d— w M����� �c.� .
(Number) (Street) (Suite#)
,/�� � �� ��
Building/Complex Name: 1 d 1�% K--�� �'�.E;����� ', Description of Transmittal/List of Changes, Items Attached:
Applicant,lnformation ^ �%�� �� ��
- �C,f�S
(architect, contractor, owner/owner's rep)
Contact Name: l�-�V����- �.1��i�eJC l C G'�I
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 informatio�t and plot plan,to comply with all Town :;
ordina_nc�e and state I�ws, and to build this structure according '!Electrical: $
to the town's z3r�i�g arxd subdivision codes, design review ap-
proved, Internation Building and Residential Codes and other Mechanical: $
ordinances of,the To n��pplic�tal� thereta
X �,:;::'�,;i /y . / Total: � .
Owner/evo',i�r' Repres tati Signature(Required)
Date Received:
p � � � o � �
For Office Use Only:
Fee Paid: AP� O � �io9p.
Received From: Eb e't
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: T�v v N �F VA I�
Authorization# -