HomeMy WebLinkAboutB14-0325_Transmittal Fire_1456789020.pdf ,411% Department of Community Development
75 South Frontage Road
TOWN OF VAIL ' 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: 0 Revisions
Response to Correction Letter
p2J!4 - O L'1'1 - (9- - 4 3 Z 3 S t-teu , t/ I. .LIVS I—I attached copy of correction letter
/ 0 Deferred Submittal
2.4, ((o co Other (r\rcp40- J ctiEr diti+.c
Project Street Address:
4 N yr 4
(Number) (Street) (Suite#) .
Building/Complex Name: f%.-11/66. T LAME p -pubo Description of Transmittal/List of Changes, Items Attached:
Applicant Information
�(!L� M.A. Stl1- . - i/v 5 P�LTl. ../
aeigcr
(architect,contractor,owner/owner's rep) u
Contact Name: A(.lyyA BJLS
Address: r• 0, 620 K. 3 3 S
City -P`G State: (..AD Zip: a
I Contact Name: b> . '2 01 e (r?j fit, (use additional sheet if necessary)
Contact Phone: Building Permits:
� 1 Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: UJ4- -t A _ • L.Alet./ (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,
I 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.
X 42.'r14n6m- 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#