HomeMy WebLinkAboutB14-0098 REV3 Department of Community Development
75 South Frontage Road
'i TOWN OF VAII va�i, co s�ss�
Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
; TRANSMITTAL FORM
�I Use this form when submitting additional information for ptanning applications or building perrnits.
This form is also used for requesting a revision to building permits. A two hour minimum buifding review
fee of$110 will be charged upon reissuance of the permit.
Application/Pertnit#(s)information applies
tO� Attention: �evisions
�Response to Correction Letter
-Tr � � �attached copy of correction letter
Q Deferred Submittal
�Other
Project Street Address:
��' Jl.�s '� (�� ��.�
(Number) (Street) (Suite#)
BuildinglComplex Name: Description of Transmittal/List of Changes, Items Attached:
Applicantlnformation �tp'''�6i�'� �r ��(�ST,�� �ql�-�S
(architec contractor neNowner's rep) T--+�—���b�t �'����� � ��Y''�S•
ContactName�f�h)�,�LL`� -�T1� I���Tt�L /�� �/p )
Add ress: �(N�+� �(I�Z- MT.�c'r ;L�'S��w�S �fl �.� C t��--{'��1 �
CitY �1��''1A n1�7 State: �-'� Zip:� b 3 2� �N°�"a''�t�E7�I= �� L.o4l��uJMyL '���l�
��� -2-" (�oc.
Contact Name: ��,h��AS L.`� �C eeCfRlEcessary) �,�"/h� '�C 1� � ��
Contact Phone: � 7J� �?6�� 9� � Building Permits:
Contact E-Mail: Revised ADDITIONAL Valuations(Labor 8�Materials)
(DO NOT include original valuation)
I hereby acknowledge that I have read this application,filled out Building: g
in full the information required,completed an accurate plot plan,
and state that all the infoRnation 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 bui�d this structure accordin
j 9 Electrical: $
� to the town's zoning and subdivision codes, design review ap-
proved, Intemational Building and Residential Codes and other Mechanical: $ Q -
ordinances of the Town applic eto.
�( Total: $0 c�fl, QO�j
�Owner/Owner' epresentative Signa u (Required)
Date Received:
or Oftice Use Only:
ee Paid:
eceived From:
� Check#
C: �sa/MC Last 4 CC# exp.date:
uthorization#
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