HomeMy WebLinkAboutE15-0045 REV2 transmittal �...._--------..._
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' �"' � f�r� Department of Community Developrnent
j 75 South Frontage Road
i �; Vaii, CO 81657
���� �� ����"n� ,�--" � Tet: 970.479.2128
www.vailgov.com
Development Review Coordinator
Tl�ANSM 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 building permits. A two hour minimum building review
fee of$110 wil(be charged upon reissuance of the permit. ,
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Apptication/Permi##(s)information applies
`to: , '�--1� Attention: evisions
� _���� -� � r�,,� 1�_ �>� ,: Respanse to Correction Letter
� �' �attached copy of correction letter
�, 1 � .� v`l� �,�`� Q�Deferred Submittal
� v " Other
:.............................................................................................................................................................................................................................................................................................................................................................................................:
`Project Street Address:
� :
��S�:�s� �CL� �'��'�= �_ ;
iNumber) (5treet) (Suite#) ':.................._............._......................_......_...................................................
.......................................................:
�BuildinglComplex Name: >� Descriptian of TransmittaU List of Changes, Items Attached:
: ':'
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;
;. ...........................................................................................................................................................................................:.
',Applicant lnformation , �I �l�Cy
;(architec contracto ,owner/owner's rep) ���P��� C��%�� G' /'�''/�""`"'� �L1�'�'�_�
'Contact Name:
,�1,�� S,� r r�l C�vs`�kkJu��i ln� : � .
'Address: � �6� ��-
S �
?City�����/��-� �� State: �� Zip: � �`��
i Contact Name: �I��fi �/`�( 1 6-t" ;(use additional sheet if necessary)
' � `� �O�- 1�'�� .:,,�_�:�w::��:.���::��::�::. _,, ��:_:�_:.w,:�_..�:v.:._,:_�...:....:.:.:�_:._��.�.�:�:.
s Contact Phone: Buiiding Permits:
p / ` Revised ADDITtONAL Va[uations (Labor&Materials}
>Contact E-Mait=�'(i�C�S��'����/lS��u��rw� -T���`�+�;,!(b,Y�D�NOT include original vaivation)
�- ;: �C:
; I hereby acknowledge that 1 have read this application,filled out �Building: $ ��� ,�J� V 4�
; in full the information required,completed an accurate plot plan, �o
> and state that ai!the information as required is correct. I agree to �Plumbing: $ � G �� "�
comply with the information and plot plan, to comply with alI Town : c,`
- ordinances and state}aws, and to build this structure according ;i Electrica(: t?� G�C� $ �� �f�U r
: to the town's zoning and subdivision codes, design review ap- �
� proved, Interna �onal Buil � � Residential Codes and other :Mechanica{: $
; ordina s of e T n appli e th r.eto. ,� =
'X � �Total: $� � . �
'OwnerlOwner's Representative Signafure{Required)
: .................................................................................................................................................................................
�...............................................................................................................................................................................................: �ate Received:
n � � � � M � �
For Office LTSe Onlc: - � I
FeePaid• ��,;7� �`�� i ,i �UIU ��
Received From: �;, ,�
Cash Check#, '
CC: Visa/MC Last 4 CC# exp. date: ~~ �r,.,,
1��F°
Authorizafion# `_. . � � �` ��_.. '_�- _.__.;