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HomeMy WebLinkAboutB15-0225_B15-0225 transmittal_1438966920.pdf * Department of Community Development 75 South Frontage Road TOWN OF.VAIL r 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: C Revisions (J O (� 0 Response to Correction Letter El attached copy of correction letter 0 Deferred Submittal f Other Project Street Address: f 3 Pd P . (Number) (Street) (Suite#) Building/Complex Name: Description of TransmittaV List of Changes, Items Attached: G 1 L,S /<- 01/ Applicant Information -�-- �-Eta -S-E) c a (architect,contractor,owner/owner's rep) Contact Name: ---gLAJ in - Address: City `` State: Zip: cContact Name: . < l) Q (use additional sheet if necessary) Contact Phone: (7c,14 e.9��g - O Building Permits: n Revised ADDITIONAL Valuations(Labor&Materials) Contact E-Mail: 55 -�DOU►4 L �cJll�t~�'P-K� 'k ca»E(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: $ ordinances of the Town applicable thereto. X Total: $0 Owner/Owner's Representative Signature (Required) Date Received: r © SHE For Office Use Only: Fee Paid: AUG 7015 0 / Received From: Cash Check# CC: Visa/ MC Last 4 CC# exp.date: TOWN OF VAIL Authorization#