HomeMy WebLinkAboutB14-0237 REV1 transmittal Department of Community Development
TOWN DF VAIL � � 75 South Frontage Road
-- Vail, CO 81657
� Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Use this form when submitting additional information for pianning appiications 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
�' � L G�J � �� �������� !�S ( ) Response to Correction Letter
attached copy of correction letter
�� � —6`�? 5 ( ) Deferred Submittal
( ) Other
._ .� .._. _ . .
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_ _ __ _..._�.._..__. ....
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Project Street Address: '
--�-1-`—'"�_ /��• �1 vt�
(Number) (Street) (Suite#)
Building/Complex Name:lnl�n-�„b�L��(L Description of Transmittal/List of Changes, Items Attached:
_ . ; . {�
Applicant;Information - °��r'�D �,� C..,d-{C� 'o� (�:�,f�S
�
(architect, contractor, owner/owner's repj '
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Contact Name:
Address:
City State: Zip:
Contact Name:
` (use additional sheet if necessary)
Contact Phone: - -
, .__.. ._... ..... ._
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Building Permits:
Contact E-Mail: Revised ADDITIONAL Valuations (Labor& Materials)
(DO NOT incfude 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 ;p�umbing:
; comply with the information and plot plan,to comply with all Town i �
ordinances and state laws, and to build this structure according =Electrical:
' to the town's zoning and subdivision codes, design review ap- �
proved, International Building and Residential Codes and other Mechanical:
ordinances of the Town applicable thereto. $
X Total: � �
Owner/Owner's Representative Signature(Required)
Date Received:
� � M �
;� ,a �
For Office Use Only: �
Fee Paid: 9 JUL 14 Z014
Received From: � �
Cash Check# ��
CC: Visa/MC Last 4 CC# � ��M V 1 V �� VA�L
exp. date:
Authorization#