HomeMy WebLinkAboutB14-0325_B14-0325 REV3 transmittal_1428080040.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL A 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: O Revisions
I O Response to Correction Letter
P 3-(4• — 02.11 $l9- - 032.5 SIA.P�(4 13eLI 1-1 attached copy of correction letter
J C)Deferred Submittal
P(LT 14 - D29q k3 W- - 0326 (s..Other IZet-rud 5n0-1.3
r-e4-c..-1-1er, debuts i
Project Street Address:
41,,Sa Pc 4 . i I lyLQ.rt�
(Number) (Street) (Suite#)
Building/Complex Name:f�/ila/F4-(-4116'Pie lex- Description of Transmittal/List of Changes, Items Attached:
J I (Lszv i Sr SN-
Applicant Information
(architect,contractor,owner/owner's rep) bar
Contact Name: AL..t. E)G{ vii S Aca
Address: 27c ( 33 88
City State: GO Zip: ta ((.31
Contact Name: &LCG�b,. p pv i s / Ac/k (use additional sheet if necessary)
Contact Phone: Q4-0 2-6 9• e. 3 c * Building Permits:
L Revised ADDITIONAL Valuations(Labor&Materials)
Q.Ic
Contact E-Mail: I-f a.�►o SST Gc.c�.. C Y 1 (DO NOT include original valuation)
I hereby acknowledge that I have read this application,filled out Building: $ erD
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 otherMechanical: $ C7
ordinances of the Town applicable thereto.
X O .)4 4:s-..» 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#