HomeMy WebLinkAboutB14-0216 REV1 transmittal Department of Community Development
75 5outh Frontage Road
T�WN QF UAIL � vai�, co a�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.
_ . _ __ _ _ .
ApplicationlPermit#(s) information applies
to: Attention: (�visions
J� ] � j , ��� /- �:`�� � ( ) Response to Correction Letter
�✓ � `� �l/ attached copy of correction letter
� �- /��� ,-? ( ) Deferred Submittal
� �...� � � JV�J� � ��-5 j�fDi:'�0��� � ) Other
_ . . .. . ...
Project Street Address:
.���I I l�' -� �r'l�vl' CM/l
(Number) (Street) (Suite#)
Building/Complex Name: � Description of Transmittal/List of Changes, Items Attac�:
, : ��F v'i'�.� I�nr� �� � �� �
Applicant Information
' � -� -e � � `
(architect,contractor,owner/owner's rep) �
Contact Na : �� /V V � I �
�
Address:
City '�'T V �� 1�-/ State: Zip:
ContaCt Name: (use additional sheet if necessary)
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Contact Phone:_ T_ � Building Permits:
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 alf 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 �wn's zoni a d subdivision codes, design review ap-
p vsd, Internati nal B ildi and Resi n ial odes and other Mechanical: $
ordi c s of th To p c I ther to
X Total: $
,`
Owne /O ers Repre n tive Signature (Requ�red)'
Date Received:
p � � � o � �
For Of6ce Use Only:
Fee Paid: ��� O / �o��
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: TOWN OF VAIL
Authorization#