HomeMy WebLinkAboutOTC13-0051 REV1 transmittal •
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°'° �'= Department of Community Development
� 75 South Frontage Road
���� �� �`�f�^� ---- va�i, co s�ss7
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 revfsion to building permits. A two hour minimum building review
fee of$110 wilf be charged upon reissuance of the permit. ,
......................................... ........� ................._................................................. ..........._........................................................ ...................................................................................................._._.....
AppticationlPermi##(s) information applies
to: Attention: �Revisions
��� � � � � �-" � �Response to Correction Letter
�'� I �\ � �attached copy of correction ietter
�a �Deferred Submiital
; ��z�'Vl�� � , �Oiher
[... � ..................................................................................................................................................................................................................................................................................................................................................................................:
, ,. . ,», ._ . . _ ,_ . ,
€Project Street Ad r)ess:
; ����' �( /� 1, Y l:�c>�-� ���C�G,-
:(Number) (Street) (Suite#) :..........................
, ............. .............................................................................................................................
Building/Complex Name:f1�" l t �l������ � = Description of TransmittaU List of Changes, Items Attached:
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.. . ... . ........ .. ... .......... .... .. . . ...................... ... .. ... . . .. ��-�����-� ��� a� �--��o����
;Appficant lnformation 1 �_�_._
��! P-T:. (.7 O{Z- �� (��. +l �
;(architecf,contractor,owner/owner's rep)
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�Contact Name: �� i� n�z' � �J��f I��v .
!Address: � '�� �� ` t
,
<City �+fYS I�L State: �� s Zip: `� � � 3
j'1��� :S Js'p.y-S�
<Contact Name: �
,
;(use additional sheet if necessary)
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:Contact Phone: 'Buitding Permits:
p,� �'�v���l �� � `'Revised AQDITtONAL Va[uations (Labor&Materials)
;Cantacf E-Maif: /- � ✓- l� 'C� >(DO NOT include original valuation)
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; I hereby acknowledge that 1 have read this application,filled out �Building: $
; in tull the information required,completed an accurate plof plan,
� and sfate that al!the information as required is correct. I agree to Plumbing: $
: comply with the information and plot plan, to comply with al(Town ;
ordinances and state laws, and to build this structure according ;;Electrical: $
> to fhe town's zoning and subdivision codes, design review ap-
; proved, International Bui{ding and Residential Codes and other ;Mechanical: $
; ordinances of the Town ' ab(e thereto.
;X ;`Total: $�
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�OwnerlOwner's t � ignature(Required) �
:............................................................................................. � .....................................................................................> �ate Received:
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For affice IIse Onlc: ' �°' �
Fee Paid: s,� lu k
Received From: n
Cash Check#. _y.�.T�W�.�.✓F �A��,.�
CC: Visa/MC Last 4 CC# exp.date:
Authorization#