HomeMy WebLinkAboutB15-0375 transmittal.pdfDepartment 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 re issuance of the permit. ,
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i Application/Permit#(s) information applies
!to:
' 8\5-03'15
Attention: (}Revisions O Response to Correction Letter
il_attached copy of correction letter O Deferred Submittal -
, ()other __________ _
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j Project Street Addre~s: . A-l l ( ~o WJ:.o\~ &&JJou c
/ (Number) (Street) (Suite#} ~ ................................................................................................................................................................................. ,
i Building/Complex Name: ~ Description of Transmittal/ List of Changes, Items Attached:
1::::::~~-~;~~;~t;~y---:------------1 ~f;k~~g~ B4
lcontact Name: l'-"t"\t-''-' l Y <A.,__>D -I
1 to~ 10&G=-e Q f'·Ou24-)ov1\. _ !. \Address:___________________ ~
1 G.££o~M1 l1.1nii\f()~.--uf?Jt i
~ ~-,D /') P,,"-\Vl ~ ~ <:.) ! ' (\(.£,.t ~.~ "'J. l.1 I~ l'> ;
I:::::::. ~=°t===7=a===-==4==,===' ===='=lf==Lf===7===·====== ~~~~·-":-=-~~ ( i! Revised ADDITIONAL Valuations (Labor & Materials) ! Contact E-Mail:------------------~(DO NOT include original valuation)
I hereby acknowledge that I have read this application, filled out
in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to
comply with the information and plot plan, to comply with all Town
I Building: $-----~---! I Plumbing: $ ________ ~
ordinances and state laws, and to build this structure according ,i Electrical:
to the town's zoning and subdivision codes, design review ap-
, proved, International Building and Residential Codes and other l Mechanical: I xrdinances oft~e Town app~~able thereto. l Total:
$ ________ _
$ ________ _
$0
i Owner/Owner's Repres tative 1gnature ( equired)
'
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~ L ............................................................................................................................................................. ···--·--·---·········-········J Date Received:
For Office Use Only:
Fee Paid:-------------------
Received From:-----------------
Cash _________ Check# _______ _
CC: Visa / MC Last 4 CC# exp. date: ____ _
Authorization#-----------------
JUI~ u ti !016
TOWN OF VAIL