HomeMy WebLinkAboutB11-0496 REV21 transmittal .__,,....
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/ Department of Community Development
; 75 South Frontage Road
TOWN OF VAII' � vaa, co s�ss�
` Tel: 970.479.2128
www.vailgov.com
``��.._.e._..�..___--�''' 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.
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Application/Permit#(s)information applies
to: Attention: �Revisions
-7 �Response to Correction Letter
���-� �� ` U ��� �-��� � 11attached copy of correction letter
�Deferred Submittal
�Other
;Project Street Address:
�� l,v . LjGI�_S��f�G� �j�C LG�. _
(Number) (Street) (Suite#)
Building/Complex Name: � �i`-1 i l l� �/��� L�Gi'U Description of Transmittal/List of Changes, Items Attached:
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— �'�7�-l���'�%� ('��4�� �� :S�C=�S
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name: �}���-
Address:
City State: Zip:
n� ��Contact Name: ��� " � �-/��' (use additional sheet if necessary)
Contact Phone: Building Permits:
Contact E-Mail: J����`a`� ����- �— � � Revised ADDITIONAL Valuations(Labor&Materials)
(DO NOT include original valuation)
I hereby acknowledge that i have read this application,filled out Building: $
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
ordinances and state laws, and to build this structure according Electrical: $
to the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Mechanical: $
ordinances of the Town applicable thereto.
�( Total: $�
Owner/Owner's Representative Signature(Required}
Date Received:
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For Office Use Only: �� '
Fee Paid: F�g 1 6 ���b � �
Received From: I�
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Cash Check#
CC: Visa/MC Last 4 CC# exp,date: "���'�j�, �y- `�,���-
Authorization#