HomeMy WebLinkAboutB14-0216 CR1 transmittal Department of Community Development
75 South Frontage Road
TOWN OF VAIl.' vau, 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 buiiding 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 upo^, reissuance of the permit.
_ _ _ _
Application/Permit#(s) information applies
to: Attention: ( ) isions
7 /-�� ( Response to Correction Letter
"��� ���-��� � attached copy of correction letter
��, ��nG? ( ) Deferred Submittal
� ( ) Other
_ . . . .
Project St eet Addre :
��� � � � �� .
(Number) (Street) (Suite#)
Building/Complex Name: �– Description of Transmittal/List of Changes, Items Attached:
' � �CjP�,�S •
Applicant Information
P � • � - � - � �� . ;
(architect, contractor,owner/owner's rep) _ �� �4 �
C� �� �
Contact Name: e..J ��I �
Address: �� i �,�� •� � � ' � a � •V�i��e��.►�.p
y .,�� � �p b� ` � 3. O - �-dde��-�G
Cit State: � Zip:�_
Contact Name: ���Q�n�' I L 1�D l, ( �r °�"-��-5
(use a d ional sheet if necessa ) �
��b U�� 1 l0�4-91 . _p��s . a-r� tin�l P
Contact Phone:_ Building Permits:
Contact E-Mail: ( � /�Revised ADDITIONAL Valuations (Labor&Materiais)
l , ��jb0 NOT include original valuation)
I hereby acknowledge that I have read this application,filled out Building: $ QU U Cy�/J�_
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 compfy with all Town ;
� ordinances and state laws, and to build this structure according ?Electrical: $
to t o n's zoning and subdivisior,codes, des' review ap-
pr ed, ternatio I B 'ding nd Reside ' I o s and other Mechanical: $
rdina c of th T n ppli le theret .
. Total: $
Own /Own s e entati e ig ature ( uired)
Date Received:
For Oftice Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: _
Authorization #