HomeMy WebLinkAboutB14-0153_B14-0153 REV1 transmittal_1420846260.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAII ' 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: ID Revisions
/� N��; Response to Correction Letter
b / — 4/573 ,-� ...�. ,: .- i attached copy of correction letter
0 Deferred Submittal
et;,; 0 y4 0Other
Project Street Address:
? , `( f'kart'-r -6.ice. / 1)
(Number) (Street) (Suite#)
Building/Complex Name: r��i-✓ lU r
-
Project of Transmittal/List of Changes, Items Attached:
Applicant Information 5 AG�.l2/ '`.,�'iGu i, 7
(architect, ontractowner/owner's rep) f � �
o ,
Contact Name: UE. 8 b 0.4• S (-C.-
Address: )5-( 3 ISl f2CIt JC•rQLL ,)
City ef-NON l7/ State: CO Zip: q I2 I Z"-
Contact Name: /7(04.f}-N 0 A Cl Ir (use additional sheet if necessary)
Contact Phone: Y.c/ `.eJ(: J — ‘..O/O Building Permits:
/ Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: ;'1 7Y >.6? ,5;;,3 �7'' 5'y-10-,-�1C (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: $
ordinanof e To/w�ap licable thereto.
X i/ cr,�y 4-1.---- Total: $0
Owner/Owner'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#