HomeMy WebLinkAboutB15-0155 REV1 transmittal :y'�"':� ` Department of Community Development
_� 75 South Frontage Road
s Vaif, CO 81657
��'�� �� ����- '� Tel: 970.479.2128
www.vaiigov.com
Development Review Coordinator
TRANSM ITTAL FORM
Use this form when submitting additionai information for planning applications or building permits.
This form is also used for requesting a revision to buifding permits. A two hour minimum buiiding review
fee of$110 wili be charged upon reissuance of the permit. ,
,
;ApplicationlPermit#(s)information applies
'to: Attention: � Revisions
, -• " a �Response to Correction Letter
f�.. - " '��- �
� � � � _w .. � �attached copy of correction letter
�Deferred Submittal
�'�I S -�� ��.
(�Other
............................................................................................................................................................................................................................................................................................................................................................:
Project Street Addres,s; - F � ; ;
.,. �
iNumber) (Street) (Suite#j :..................................................................................................................................................................
Building/Complex Name: " x�` �°�"3 Description of TransmittaU List of Changes, Items Attached:
_...................._................__........_........._......................................................................:
;;Applicant Information
;(architect,contractor,owner/owner's rep) ,
;
` , , .��.
i Contact Name_
Address:
;City State: Zip; 1
€ContaCt Name: »�°` ;;!(use additional sheet if necessary)
; � �,.,. . .: -: _ ,,: . ;.:, ... --,::. _:�;
Contact Phone: - � Building Permits:
" �, Revised ADDITIONAL Va[uations (Labor& Materials)
Cantact E-Mail: ;;(DO NOT include original va{uation)
I hereby acknowledge that{ have read this application,filled out Building: $
:: in full the information required,completed an accurate plof plan,
and state that all the in#ormation as required is correct. I agree to :Plumbing: $
€ comply with the information and plot plan, to comply with all Town ::
i ordinances and state laws, and to build this structure according ;;Electrical: $
' to the town's zoning,a d subdivision codes, design review ap-
;! proved, Internati�t��l uilding and Residential Codes and other ;:Mechanical: $
ordinances -the wn applicable thereto.
�,....,��.._. . Total: $� ,
,. ,
Owner/Own Representative Signature{Required) _......._...................................................................... . . ................_ .....................;
:................................................................................................................................................................................................
Date Received:
� � � � � � �
For Office IIse Onlc:
Fee Paid: �uL 1 L� 2��5
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# eXP.date: TOWN OF VAIL
Authorization#