HomeMy WebLinkAboutB14-0120 CR1 transmittal Department of Community Development
75 South Frontage Road
TOWN OF VAIL ` va�i, coe�ss�
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 requesiing 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: Q Revisions
� t� �C� _ l� I Z i (J Response to Correction Letter
� �� �\�"✓� ��i �attached copy of correction letter
Q Deferre��i e n!� �
�Other � ��
�
Project Street Address:
�_ �" . <���,��. Cre�k �� 3�i�13���
(Number) (Street) (Suite#)
Building/Complex Name:��)(�.C;,� �'ci�'- �{�t Description of TransmittaV List of Changes, Rems Attached:
Applicantlnformation ��� ��� \����������
�) ���i'u�� 1`�(�2-1- �>�'
(architect, contractor, ownerlowner's rep) ,
Contact Name: ��('r �`)� ��\ (�Q �e ` d ' � `�� �� -
Address:
��tY State: Zip:
ContactName: �'�3 Y!l'�/�
Q �(� (use additional sheet if necessary)
Contact Phone: \ � �> �3 l� � 7 � � guilding Permits:
Contact E-MaiC �-].�V([� A.'1�"�J�( .YJj �� 1�..1 j�� �r�e°ised ADDITIONAL Valuations(Labor& Materials)
( O 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 correcL 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 the town's zoning and subdivision codes, design review ap-
proveee���YYY Ir�ternational Building and Residential Codes and other Mechanical: $
ordi�e f,th�To n �pplicabl ereto.
X �l� � Total: $0
Owner/Owner's Repr entative Signature(Required)
Date Received:
For Offiee 1�se Onlv-
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#