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HomeMy WebLinkAbout12. B13-0034 REV5 transmittalDepartment of Community Development 75 South Frontage Road T WN OF VA1l. vai, co s ss Tei: 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 b t i Response to Correction Letter Y attached copy of correction letter p '/I Deferred Submittal S i-1_7 `I V ( ) Other Project Street Address: rEJ El//'h-/' / f / Number) (Street) Suite#) Building/Complex Name:Description of Transmittal/List of Changes, Items Attached: il/dc•d.li!' Applicant_Information architect, contractor,owner/owner's rep) Contact Name: Address: - G' City State:Zip: /l S Contact Name: -"+ /use additional sheet if necessary) d v CJ 3ContactPhone: Building Permits: Revised ADDITIONAL Valuations (Labor& Materials) Contact E-Mail:o/' lJ 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: C,C7 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 nd s bdivision codes, design review ap- proved, Internati i g e ' ential Codes and other Mechanical: ordinances e a c re X Total: Owner/Ow er s Represent ve Signature(Required) Date Received: For Office Use Only: Fee Paid: Received From: Cash Check# CC: Visa/MC Last 4 CC# exp. date: Authorization#