HomeMy WebLinkAboutB14-0032 B13-0552 REV1 transmittal Department of Community Development
` 75 South Frontage Road
TOWN UF VAlL' �\ " va�i, co s�ss7
Te1: 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/Pert�rit s ' ormation applies '
t •.----�.,� ` � Attention: (,�Revisions �
�� � � se to Correction Letter
B14-o03 d 613-0552 ���j--�� �_ �attached copy of correction letter
(a Deferred S �ftal
(Q Other
Project Street Address:
463/473 Beaver Dam Road
(Number) (Street) (Suite#)
BuildinglComplex Name: Description of Transmittal/List of Changes, Items Attached:
Temporary Shoring Design
Applicant Information
(architect, contractor,owner/owner's rep)
Contact Name: RA Nelson
Address: 51 Eagle Rd
City Avon State: �� Zip: 81620
ContaCt Name: Grant Smith (use additional sheet if necessary)
Contact Phone: 970-391-9736 Building Permits:
gsmith@ranelson.com Revised ADDITIONAL Valuations(Labor 8�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 information and plot plan,to comply with all Town
ordinances and state laws, and to build this structure according Electrical: $
to the to 's zoning and subdivision codes, design review ap-
prove , Intelyational Building and Residential Codes and other Mechanical: $
ordin nces of�he To applicable thereto.
X Total: $�
Owner/Own epresentative Signature (Required)
Date Received:
p � � � odc�
For Office Use Only: I /�
Fee Paid: J�N �6 �O�T
Received From:
Cash Check# T0�/� �� �/�q,L
CC: Visa/MC Last 4 CC# exp.date:
Authorization#