HomeMy WebLinkAboutB13-0146 ILC transmittal Department of Community Development
75 South Frontage Road
TOWN OF UA1�. � vai�, co s�ss7
� 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
/ ( ) Response to Correction Letter
)�j� 3— 0��[� attached copy of correction letter
�� '���� 1 C ( ) Deferred Submittal
, ( ) Other
Project Street Address:
_3�.1.� ��(,�t'l`�l�-i:=L. G� (�-�
(Number) (Street) (Suite#)
Building/Complex Name: R��U `� �.����C�- Description of TransmittaU List of Changes, Items Attached:
Applicant,Information ���,�����l�UV�� �����J�J
� L�
(architect, contractor, owner/owner's rep)
Contact Name: �S-f��`� �� ��,�
Address: �� �� �� � `�
City )�I�W i�n S State: G� Zip:_�'�'//�?��
ContaCt Name: v�`y'�Y �-1, ��_ (use additional sheet if necessary)
Contact Phone: ��Q � "l� � L � .._7 Building Permits:
�-...�- .-Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: (��-../��l��_� �-�rtJ��i ��,�'���(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 To ap ' ble thereto. ^
X � Total: $ \�
Owner/ wner's Representa ve Signature (Required)
Date Received:
�-a5`�`f
� � � � �I �
For Office Use Only: D
Fee Paid: App � C �o��
Received From: fif ti J
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: TOWN OF VAIL
Authorization #