HomeMy WebLinkAboutB14-0096 REV2 CR1 transmittal q'�'� ` Department af Community Development
�fi 75 South Frontage Road
T��� ��'U�����'� va��, 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
G} � - ' �Response to Correction Letter
� � '-' �Q < �1 � �aftached copy of correction letter
s��,�, Q��� � � r � � � �Qeferred Submittal
� V f�Oiher
.....................................................................................................................................................................................................................................................................:
__._._._..__............... _..............___...._........- -._.......__._ ._...._.....__.............................................. ....._........
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Project Street Address:
; `z75 -��-���u� v �O�'�l �lr��
€�Number) (Street) (Suite#)
; Building/Complex Name: �� �4>�'-P�ri'�� < Description of Tra smittaU List f Changes, Items Attached:
;
:
._._.. ... . _ . _ . ..... . . .... : 5-t�c�,G � � � -.��� , ..e�P�
(;Applicant Information _ �-
`��,( /✓ �j —{��L c5 I Z�
;(architect,contractor, n /o er' r p) �
- �(��5�
`Contact Name: �
Address:�i( .� Nr l ��6 fn �if � 'v/O �
;Ciiy � .� State�O� Zip:
!Contact N2me: �[ � ;, (use additional sheet if necessary)
, ��, " - >:>:. . . .. :::: _ ,:� <,:_
Contact Phone: Building Permits:
� Revised ADDIT{ONAL Valuations (Labor&Materials)
Contact�-Mail: ; DO NOT include original valuation)
l�l l/��. . C:L��� LL�
! I hereby acknowledge that I have read this ap cation,filled out ; Buiiding: $
!: 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 :
I ordinances and state laws, and to build this structure according ;;Electrical: $
to the town's zoning and subdivi � co s, design review ap-
; proved, Intarn tio Bui ing d Resid nfial and other ;MechanicaL $
� ordi es th ow pp�ca th et .
;'.X � Total: $�
*
: >
;
Owner/Owner's Representativ ignatu (Required) '
':...............................................................................................................................................................................................: Date Received:
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For Office LTSe Onl�•:
Fee Paid: ��L 2 2 �0��
Received From:
casr, Check# TOWN OF VAIL
CC: Visa/MC Last 4 CC# exp.date:
Authorization#