HomeMy WebLinkAboutB13-0508 REV3 transmittal °��� Department of Community Development
75 South Frontage Road
TOWN QF VAIt: :: va�i, 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
' '�� � �attached copy of correction letter
� Q Deferred Submittal
�Other
Project Street Address:
I ,�� ����s�r P�.
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant Information ��r�� ������� �'r����'�T—
(architect,contractor, owner/owner's rep)
Contact Name: ��'V(.., � �lr
Address: ��U• �6�( 0 U �d-
City /-tc/(�.n State:�Zip: � ��
ContaCt Name: Cj��(�P�,SQ✓� (use additional sheet if necessary)
Contact Phone: �7(�' � 7��(�� / Building Permits:
,_ Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail:����Si✓t''S'�Ct�ctiS�"(:.����Y1 ,(.�>",�✓l (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 accerding Electrical: $
to the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Mechanical: $
ordinan ef the Town applicable thereto.
X����/�� _ Total: $�
L
Owner/Owners Representative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#