HomeMy WebLinkAboutB14-0361 CR1 _ Department of Community Development
i 75 South Frontage Road
TOWM QF VA�L � vai�, CO 81657
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. u
Application/Permit#(s)information applies
to: Attention: Revisions
/ � Response to Correction Letter
/� �� � � ��Q � �� attached copy of correction letter
��c�-�(,� —� �� Q Deferred Submittal
(o Other
Project Street Address:
y;,:�o ��i� 2AC�uFr Ci.t��3 �� .# �
(Number) (Street) r (Suite#)
Building/Complex Name:���r�� �fT�q�l� f � L[,(�j Description of Transmittal/List of Changes, Items Attached:
$V�l 11�1N i9 1� i��v"�S� 1�(,�1� s
Applicant Information
��1�'�s5 i✓�4 C o r!'e��`r v �
(architect, contractor,owneNowner's rep)
Contact Name: ��F F�� IZ L I�-_
Address: ��X �5�
City V�'� � L State: �fl Zip: O �� �^�
COntaCt Name: �o4•nR � (use additional sheet if necessary)
Contact Phone: ��� ��G �'�� � Building Permits:
Contact E-Mail: Y�I�RQ 1'��}u���20Me i,,c,r � ,;,.,�,�}�'���Qirl Revised ADDITIONAL Valuations(Labor&Materials)
P C�'` (OM (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: $
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 ing and subdivision codes, design review ap-
proved In e�r ati nal Building and Residential Codes and other Mechanical: $
ordina e th Town plicable thereto.
X Total: $�
Owner/ presentative Signature(Required)
Date Received:
For O�ce Use Only D � � � � \'/ �
Fee Paid:
Received From: ��� � � ����
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#
1`��� C9� VAI L