HomeMy WebLinkAboutB15-0294_B15-0294 REV1 transmittal_1446738420.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL Vail, CO 81657
Tel: 970A79.2128
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: $Revisions
0 Response to Correction Letter
CaIS — OD,(, (_ n attached copy of correction letter
0 Deferred Submittal
0 Other
Project Street Address:
(Number) (Street) (Suite#)
Building/Complex Name: ( )(t I P{LC1.rtrC 0 T± Description of Transmittal/List of Changes, Items Attached:
(A 7-x-t i-t ( "lz!IBJ l raj-,
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name ,V Li nil Q ( t l(.IAA(('OJ .,
S (\ ry4 yl (l7
Address:
City L ' State: C.c Zip: S (31
Contact Name: ( _Ort 1 (YtOt- ( (use additional sheet if necessary)
Contact Phone: 01'10. ` 7 • 'ate Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: i Ort Y( ran ol V\fN1tcVACLh\i cid.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 _•• Residential Codes and other Mechanical: $
o diva Ices of the n applicable iereto.
Total: $0
0 ae,Ow,er's epre =ntative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#