HomeMy WebLinkAboutB14-0071 REV1 transmittal " �' � ` � ( Department of Community Development
� \ 75 South Frontage Road
TOWN OF VAIL °- � 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 pianning applications or building permits.
This form is also used for requesting a revision to building permits. A iwo hour minimum building review
fee of$110 will be charged upon reissuance of the permit.
Application/Permit#(s) information applies
to: Attention: (�Revisions
' �' � l.� � � � � � �� ( ) Response to Correction Letter
fi—� attached copy of correction letter
'�� �_�i'�j� ( ) Deferred Submittal
( ) Other
_ . . .
Project Street Address: „
���;S _ S>v�;�; �c�,'���y ��-- �
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
° _ 1..;"I�i ' �.�v.,�.. �rJ�� �
Applicant Information j
(architect, contractor, owner/owner's rep)
--�6; �i���,��.� ��,,�.�
,� � � �
Contact Name: � ��� kC�7��.z L�.>7� j
Address:
City State: Zip: �
ContaCt Name: (use additional sheet if necessary)
--7 '� ,, , ... .... ... . . . _. . . . .._ . ._ ...
Contact Phone:__� � � — � / �� Building Permits:
Contact E-Mail: �� ��� �1��C- o N''�� Revised ADDITIONAL Valuations (Labor&Materials)
;(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 subdivisior,code sign review ap- ,
' proved, International Building and Resi ial Codes and other Mechanical: $
� ordinances of the Town applicable reto. ,
X - Total: $ �i .�
Owne Owner's Representative Sig ature (Required)
Date Received:
nC� C� C, OMC
For Office Use Only: i I
LJ
Fee Paid: ��� i � �0��
Received From: .L
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: „�.��� �� ����
Authorization #