HomeMy WebLinkAboutDRB140219 transmittal Department of Community Development
75 South Frontage Road
TOWN OF VAII va�i, cos�ss�
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
- � �y'� �(Response to Correction Letter
'��'�`7 '���% 'l�1/J ���\U`((Q �'� �attached copy of correction letter
(J Deferred Submittal
!p Other
Project Street Address:
� � . �(11Lp (�YPQ'�. �V2— Z Z_
(Number) (Street) (Suite#)
e C
Building/Complex Name: �������� Description of TransmittaU List of Changes, Items Attached:
�(�C`� � \v��' ar. ,i—� .
Applicant Information
(architect, contractor,owner/owner's rep) '—����� ����
Contact Name: ���� ��1�. ����� �m�—����
Address:
City State: Zip:
1 `
ContaCt Name: �h (use additional sheet if necessary)
Contact Phone: � 1(� C7�1�y- Building Permits:
`�\�`(�,1i ll `�'�✓K i�I �(\cJ : lC(Y7 Revised ADDITIONAL Valuations(Labor&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 town's zoning and subdivision codes, design review ap-
proved, I e national Building and Residential Codes and other Mechanical: $
ordinanc f tl e T wn a plicable thereto.
X 6 � � � �' ,If� Total: $�
Owner/Owner's Represen(a(ive Signature(Required)
!/
Date Received:
I�ar Offim Usc Onlv:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization #