Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutB14-0076 REV1 � Department of Community Development
� 75 South Frontage Road
T�WN (1F VAII� va�i, co s�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 requesting a revision to building permits. A two hour minimum building review
fee of$110 will be charged upon reissuance of the permit.
_ ._ _ __
_ _ __ _
_ _
Application/Permit#(s)information applies
to: Attention: � �Revisions
��� � /'(°�`-\"�� '�4�� � �j Response to Correction Letter
v`-' 1 � �attached copy of correction letter
���� �`��� Q Deferred Submittal
(('�Other
Project Street Ac�dress: ,
IQQQ ��Ql'�31 1�
(Number) (Street) (Suite#)
Building/Complex Name: V,��U� �Q� Description of Transmittal/List of Changes, Items Attached:
_ _. . _. _. .. _.. .. �j��- a� C�,�'�vt i�- j�'� � t�, � ,...,
Applicant Information
..l' ���
(architect,contractor,owner/owner's rep) �,
��� �^� �—�
�ontact Name: �+1�1 L � ���
/ �7 , �
Address: ID G � � �� l� �'�� .S�' R � LC� �
�
City �►4.�►�� State: � Zip: ���/
Contact Name: �� V �Q�.(�� T(� (use additional sheet if necessary)
Contact Phone: �l�l� `Z�.� " � �$� guilding Permits:
�' ��b��,� � � � "� ��.Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: IVr1,1 '� �"41 ° (DO NOT include original valuation)
I hereby acknowiedge that I have read this application,filled out Building: $
in full the information required,com leted an accurate plot plan,
and state that all the informatio a required is corre . I agree to Plumbing: $
compl with the information a p t plan, to comply ith all Town
ordina ces and state I , s, a t uild this according Electrical: $ ��4� '
to the wn's zoning and ub is n co s, design iew ap-
rove atiana uil g n denf nd other Mechanical: $
rdina f the To ap li b e . �� �,
Total: $p 2(�,� �
Ow / s res t f ( equir )
Date Received:
� `V� � � V �
For Oflice Use Only: D rl
Fee Paid: ��� � v ����
Received From:
�ash Check# TOwN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization#