HomeMy WebLinkAboutB13-0481 REV4 transmittal �� Department of Community Development
75 South Frontage Road
TOWN OF UAIL � v va�i, 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.
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Application/Permit#(s) information applies
to: Attention: ( ) Revisions�
�/ � ( ) Response to Correction Letter
,� r3-��g� ��" � �� attached copy of correction letter
n,�J ` �,O/' � q O Deferred Submittal
J" , 1�-'r�-/ �ther
Project Street Address:
/�C.�Q //Ur�.S-i��d.��7lf c�i2l I1s'.=
(Number) (Street) (Suite#)
Building/Complex Name:C�S'Cflz�` /��-���%'�S''�A `: Description of TransmittaU List of Changes, Items Attached:
_ : /�S"`�LC/�7S"
Applicant,Information ,
(architect,contractor,owner/owner's rep) -
Contact Name: �/Zi✓S�`' �Sn'2L��T/a'"`� ��'C
Address: %��� ���G/y
City /'�i�/'v�� State:�� Zip: g����
ContaCt NBme: ��u�� �s�''�' ' (use additional sheet it necessary)
,.. : ,.,... . . _..... , .._.. ._... _,.. .... .
_._ .. . ._.
Contact Phone: 7� �� ���7 Building Permits:
Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: �r�«J'" �S�'"��l%'7^ cc�^e'7 (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: $
cornply 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 zoni and sub � ision codes, design review ap-
proved, Internati al Buildi and Residential Codes and other Mechanical: $
ordinances of e Town licable thereto.
X Total: $
Own !Ow r' R re tative Signature (Required)
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/ Date Received: ��7//�c
.
� � � lJ t/ �
For Office Use Only: �
Fee Paid: �UL 1''� 2014
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: '�'QWN C�F VAIL
Authorization#