HomeMy WebLinkAboutB15-0045.001 Transmittal 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: Q Revisions
� I , .l Q Response to Correction Letter
OD Li —'-- n attached copy of correction letter
Q Deferred Submittal
0 Other
Project Street Address:
6; h��� 12.E u 1- A
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant Information
�1 0., \-
(architect,contractor,owner/owner's rep)
Contact Name: e \r
Address: L Z
City v <21
<< l State: (.5 Zip: v `6
Contact Name: 2 C._ - (use additional sheet if necessary)
Contact Phone: �7'' "Yo- Building Permits:
1 J� Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: ``�- ��f �ww� (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: $ /C�� j 0,>
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: $0
Owner/owner's epresentative Signature (Required)
Date Received:
�
iv
For Office Use Only: D ��� � ' i ��,
Fee Paid: g
Received From: MAR 3 _' 2015
Cash Check#
CC: Visa/MC Last 4 CC# exp.date: !
Authorization# 'T o V N .F VAIL L