HomeMy WebLinkAboutB14-0180 REV1 transmittal Department of Community Development
75 5outh Frontage Road
TQWN OF VAIL � vai�, 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 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: Q�Revisions �
��'r � c i 7_, �����i� ( ) Response to�orrection Letter
[+'-' �"� �J attached co of correction letter
( ) Deferre Sub ittal 'l J
( )Other�5 � f7 ��!I'�i,IfY.���
Project 5treet Addres : I �� c�
_S� �s °l.la(' �Y1/ , u �_
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmitt I/List of Chan es, Items Attached:
. �
J
Applicant,Information
(architect,contractor,owner/owner's rep) �>K ��71J� �
C� ,�-� , �,�(' ,� , , ...�
Contact Name: � r
I A
-Address: ? 1
�-+ �/"�!1 I
City —" State:�,Zip:�C-� � 1 i ��
Contact Name: � �-�«� ( e additional sheet i necessary
. _ . _ . ._ __ �,�p�� � � . ,
Contact Phone: `� '� Building'Permits:
Revised ADDITIONAL Valuations (Labor 8�Materials)
Contact E-Mail: �LI (DO NOT include original valuation)
I hereby ackno dge 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 i
' ordinances and state laws, and to build this structure according ;Electrical: $
to the town' zoning and subdivision codes, design review ap-
proved, In ' nal Building a Residen' Codes and other Mechanical: $
ordinan of the Town appli le here . J
X Total: $
O er/Owner � epre tive Signature(Required)
Date Received:
l� � � 0 1J �
For Office Use Only: D
Fee Paid: AUG 0 4 2��4
Received From: (�(
Cash Check# '/(/ -l���
CC: Ysa/MC Last 4 CC# eXP.da�: TOWN OF VAIL
Authorization#