HomeMy WebLinkAboutB15-0375.001 transmittal.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.
Project Street Address: D"'
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(Number) (Street)
~ention:
") ~/{\
(Suite#)
O Revisions O Response to Correction Letter
Q_attached copy of correction letter 0 Deferred Submittal
E) Other S\ l\}.§T.) '\f'\ '--"::;:.
Building/Complex Name:--------------Description of Transmittal/ List of Changes, Items Attached:
$DLD C:::\\)~ '-..__.. D~ u.) I~ b._)
Applicant Information
(architect, contractor, owner/owner's rep)
Contact Name: ~«..._\<<:_ -t bl\Q1~6\~
Address:------------------
City _________ State: ___ Zip:-----
Contact Name: ------------------• (use additional sheet if necessary)
Contact Phone:------------------Building Permits:
•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
co ply · h the information and plot plan, to comply with all Town
or inances d state laws, and to build this structure according
to e town's z ing and subdivision codes, design review ap-
pro ed, lntemati al Building and Residential Codes and other
ordi ances of the Town applicable thereto.
For Office Use Only:
Fee Paid:-------------------
Received From:-----------------
Cash---------Check#--------
CC: Visa / MC Last 4 CC # exp. date: ____ _
Authorization#-----------------
Building:
Plumbing:
· Electrical:
Mechanical:
Total:
Date Received:
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