HomeMy WebLinkAboutB14-0095 REV1 transmittal Departmenl of Community Development
75 South FronWge Road
iOWN OF VAIL ' VaiI,C081657
Tel: 970.479.2128
www.vailgov.com
Developmenl Review Coordinator
TRANSMITTAL FORM
Usc this torm when suAmiBing aatlilional infortna�ion lor plannim�aOV���a�ions or builtling permils.
This fuim is also used tor reques�i�g a revision to building permi�s. A hvo hour minimum builtling ieview
fee of 5170 will be chargetl upon reissuance of Ihe permit.
ApplicatioNPermit q�s)iniormation applies
to: AHention: evisions
�2 � LI _ /-���1�� –rn . Response lo Correclion Letler
�, t ` � • Y l/ v"l \�Y V�P� \� �attachetl copy o/cortection letler
0�eferretl SuDmillal
�Olher
Prqect Street Ad ress-
�1� � � � ,AC�� �_ l`�—
(Number) �Sheet) / j �SUite M)
BuiltlinglComplea Name: 1��7NY a1��VY\(_ , Descnplion ol TransmillaV Lisl of C�anges,Ilems Al�achetl:
ApplicanHnformation ��—�(� (�1r�L�
(arcnifecq conlralc�toq owner/owner's re0) ( ��� � u�n'P 7 Cl.��!W�Pn.�
Conlacl Name-. J�. �J�J ��\! T\�`l � L I � � Ml� w(�>� �
Address:
� �(�'2– ��(Yl��– K D C !1-rP� _
cay Q� s1�� ie� rv:
ConlaclName: a7;�(�},1�Y1 (useatltliliorulsheetitnecessary)
Conlacl Phone�. � \r/l����2�� � ' Building Permits:
Conlacl E-Maif. l��Y(�y l l`_'�'��� 1`�J\�C� ��M Revisetl ADDITIONAL Valua6ons(Labor 8 Matarials)
(DO NOT include original valua�ion)
I hereby ar.knowletlge Ihat I have reatl�his appliration,filletl oul Buildin9- $ ��
in full Ihe informalion reqwreQ compkted an accurate plol plan,
and s�a�e thal all Ihe informalion as required is mnecl. I agree lo plumbing: $
comply vn�h Ihe informalinn antl plot plan,in r.omply with all Tnwn
ordinances and slale laws,aM lo Ouiltl��is slmclure according Eleclrical: $
lo the lown's roning and subdivision codes,design review ap-
prove lerna�ional Builtling and Residenlial Codes and o�he� Mechanical: $
ord n f Ihe To/w� nn epVlicable I�ereto. /� �
X I 1!1 A I��� Tolal�. $0 .�—r
(hmer/Owner's R ic��ativc Si9naN�c(Rcpui�cd)
Date Receivetl:
For OR e Ilx Unly:
Fee Paitl:
Re�vM Fmm:
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(Y: Ysa/MC lari 9 CC p vP.4dYP:
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