HomeMy WebLinkAboutA16-0005.001 Transmittal.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAI f Vail, CO 81657
Tel: 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: ieRevisions
410 Response to Correction Letter
Permit#:A16-0005 Project#: PRJ14-0157 f-1 attached copy of correction letter
O Deferred Submittal
(®Other
Project Street Address:
181 W. Meadow Drive
(Number) (Street) (Suite#)
Building/Complex Name: Vail Valley Medical Center Description of Transmittal/List of Changes, Items Attached:
Areas of Rescue have been added to the Fire Alarm
Applicant Information
System
(architect,contractor,owner/owner's rep)
Contact Name: SimplexGrinnell
Address: 14200 E. Exposition Avenue
City Aurora State: CO Zip: 80012
Contact Name: Greg Mikevich (use additional sheet if necessary)
Contact Phone: 303.888.5535 Building Permits:
a : Revised ADDITIONAL Valuations(Labor&Materials)
Contact Mgreg.mikevich@oslocorp.com
(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: $25000
to the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Mechanical: $
ordina ces of h Town pplicable thereto.
Total: $25000
Owner wner's Representative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#