HomeMy WebLinkAboutB13-0508 REV4 transmittal ° a Department of Community Development
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75 South Frontage Road
IOU�N OF IIAIt � � � va � i , co s � ss�
Tel : 970.479.2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL FORM
Use this form when submitting additionai information for planning applications or buiiding 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
�- ,� - � ,� � � Response to Correction Letter
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�� • � �. � t� . � � � _ �- r �- �attached copy of correction letter
Q Deferred Submittal
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Project Street Address :
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( Number) (Street) (Suite #)
BuildinglComplex Name : �� '�,���� ��'�F` ,- ��?,Tc�,"�, Description of Transmittal/ List of Changes , Items Attached :
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Applicant Information � ` ��� � � � '� � � ' � �`�" �� � �� �� �� � � �� ��� ��� �
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(architect, contractor, owner/owner's re i~r �r � t ¢�� � �p x�fiF� t� f ` �s� ��� ��r t Fj ��
P) ���;E� �� � ." '�d 4'�- Y��^�.
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Contact Name : �� ���P �'��'- r- � � \
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Address �"` �t � ,:�� ��
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s : � i - I / � ,.,,?t`,.��'9 G:.z���� ;' .-d ��� �C ,:.'. �C' ` �., .h� `�� S-� C!� �`'C., �f�"'� .
Contact Name: �`� < � �'�_ r=, �z�,� �'"F;� -� �.x (use additional sheet if necessary)
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Contact Phone : ,� � s,� .� , � Building Permits :
�,,. ��, � � � � � , ' ° � Revised ADDITIONAL Valuations ( Labor & Materials )
Contact E -MaiL �° '- � ,�F�<,�-g 6; b. ,� �. �"�;�� �r � r,�:�� - ( 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 p�umbing : $
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-
proved , International Building and Residential Codes and other Mechanical: $
ordmances Q the Town applicable thereto.
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- �ti F..,-�¢s Total: $
Owner'!O`wner' s Representative Signature ( Required )
Date Received :
Iror Officc Usc Onlv
Fee Paid :
Received From :
Cash __ Check #
CC: Visa / MC Last 4 CC # exp. date :
Authorization #