HomeMy WebLinkAboutB14-0096 ILC transmittal _ _ .
Department of Community Development
75 South Frontage Road
TOWN OF VAiL�' va�i, co 8�ss7
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
Q ,�J� Q�� � �� � • �j Response to Correction Letter
IJ��� �attached copy of correction letter
n 1 � ` �� � 6 n�}-�-I'�`�0�� Q Deferred Submittal
�`7 f� ��u (Q Other
Project Street Add ess: ,,,� %����
�2 7 �{ C�C��'C�6'�� � L
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
— .���
Applicant Information
(architect,contractor,owner/owner's re
Contact Name:l�P C� �� Q ri��
�� ��� ��8 ���
Address: � � � ��- �/'p �`
T �
City �,_State:C�� Zip:�
Contact Name: � (use additional sheet if necessary)
Contact Phone: � `'��T Building Permits:
/" Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: � � �'`��' ^ (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 zoning nd subdi ' on odes, design review ap-
proved, Inte n �o Bui 'n nd R idential Codes and other Mechanical: $
ordina h w p ' ab .
X .� _ Total: $0
Owner/Owner's epresentative Signature(Required)
Date Received:
For Office Use Only: ,y^��i �=-� �=i !�_' � � ��' n
Fee Paid: ; 1
d ��: E
Received From: �.
�asn �ne�k# ���� MAY 0 '7 �U15 �
CC: Visa/MC Last 4 CC# exp.date: � �l '
Authorization# �..��� �� ��i�
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