HomeMy WebLinkAboutB14-0096 transmittal ° '✓'�"'"=� Department of Community Development
75 Sou�h Frontage Road
�-��� ��.����'s Vail, CO 81657
Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
TRANSM ITTAL 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 wiil be charged upon reissuance of the permit. ,
,
Application/Permit#(s) information applies
to: Atteption: �Revisions
Res onse to Correction Letter
�j'�� � """�' �� �� r� � c' �att ched copy of correction letter
�� �` /-�/�� � �Deferred Submittal ,� f �
��./V �� (�Other L
€........................................................................................................................................................................................................................................................................................................................................................................................:
Project Street Address:
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;(Number} (Street) (Suite#) €':........................................................................................._.........................
s BuildinglComplex Name: <' Description of TransmittaU List of Changes, Items Attached:
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........................................................._......_........___....___....__.._...._......................_...._...................................................; �� �
;:Applicant Information
(architect,contractor,owner/owner's rep)
'Contact Name: l�t/Gvl�L-Q. / _l I Cf�� �
Address� � ��l'la��iG -�' �, f�� �.�n
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;<City� State:� P:_�/�(S7__�;
!Contact Name: ��/` � !� (use additional sheet if necessary)
. . .::.... .. . ._::.
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;i Contact Phone: Buitding Permits:
S� /� " ':Revised ADDITIONAL Valuations (Labor&Materials)
'Contact E-MaiL�'�{� rt � ,��q(,���( J/� ' ;(DO NOT include original valuation)
G-l��'
` I hereby acknowledge that I have read this application,filled ou�; Bui{ding: $
' in full the information required,completed an accurate plot plan,
and state that all the information as required is correct. I agree to :;Plumbing: $
compfy 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 and subdivision codes, design review ap-
;j proved, Intemational Buildin and Residential Codes and other ;'MechanicaL $
__...
ordinanc�s th o ap�5� le ef . ;
'X � ' Total: $� €
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Owner/Owne�'s Represe a ive Signature(Required) ::..... ............................................................................................................_..............................._....................;
.....................................................................: Date Received:
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For Office IIse Onl�•: JUN 2, � G�1�
Fee Paid:
Received From:
Cash Check# 'r'r1�Aiw1 0� v���
CC; Visa/MC Last 4 CC# exp.date: �J Y V�V
Authorization#