HomeMy WebLinkAboutB15-0416_B15-0416 REV1 transmittal_1447265160.pdf Department of Community Development
75 South Frontage Road
TOWN OF Vail.A Vail, CO 81657
Tel: 970.479.2128
www.va i Igov.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: evisions
l �I ` C) esponse to Correction Letter
1 v r Z1f1 0 attached copy of correction letter
d Deferred Submittal
()Other
Project
Street Address: 0
-7)540
c1a-v r i tz
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached
Applicant Information
Prue dwc i S
(architect,contractor,owner/owner's rep)
Contact Name
Address:
City �� r State Zip:
Contact Name: rW" 1 (use addilional sheel if necessary)
Contact PhoneBuilding Permits:
,,, 1 (�� ��S n Revised ADDITIONAL Valuations(Labor& Materials)
Contact E-Mail Z[1�V1` t� J\A (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-
pro -.,International Building and Residential Codes and other Mechanical: $
ordi anc: of the Town applicable thereto.
XTotal- $0
•'1' Owner/O ! -r- ,+r•sentative Signature(Required)
Date Received:
For i)fficr Use Only
Fee Paid:
Received From:
Cash Check #
CC: Visa/MC Last 4 CC# exp.date:
Authorization #