HomeMy WebLinkAboutB15-0312_B15-0312 REV1 transmittal_1446226620.pdfTOWN OF~ Department of Community Development
75 South Frontage Road
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 ·-:rs IS -O 31 d--'--:f?e\J i
PK:r 1 s --a~sa ·
Proj~ct Street Ad.,dres~ _ ()_~ 13 7 () Sft1v1)S[G)vg-J~-D
(Number) (Street) (Suite#)
Building/Complex Name:--------------
Applicant Information
(architect, contractor, owner/owner's rep)
Contact Name: 1'1A./tl2. ({ S LOTT
Address:------------------
City _________ State: ___ Zip: ____ _
Contact Name: -----------------
Contact Phone: __ 3,_7_b_-----'3=--/ 9_7 _____ _
Contact E-Mail: )::otAJNN I L-L/11 pfr.2..Tfe flftlW. ~
O Response to Correction Letter
.D_attached copy of correction letter 0 Deferred Submittal
QOther __________ _
Description of Transmittal/ List of Changes, Items Attached:
-£1ec/£,tk{ £vf}lv.f++i):,f..)
-M>f:fJ.~fuM':, fifl.. +;,,~fl£ ~
~--
(use additional sheet if necessary)
Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
(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, ern t' n I Building and Residential Codes and other Mechanical:
ordinan wn applicable thereto.
X Total:
Date Received:
For Office Use Only:
Fee Paid: _________________ _
Received From: ----------------
Cash _________ Check# _______ _
CC: Visa/ MC Last 4 CC # exp. date: ____ _
Authorization # ----------------
$ ________ _
$ Zo~
$ ________ _
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