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HomeMy WebLinkAboutB16-0141 CR 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. , f"ip.p°il~ti~-~,p~;~it.#(;)··l~f~~~;ti~~--~p-pll~~---····················-·················································································· .. ·········· .. ·· .. ·························································-·······························-···································1 :''' ·,,::_i "'J3 j {J ~ Q J l{ L ~ J Attentiono w.E~:~s to Correction Le~~ :tier .i 0 Deferred Submittal , O O,ther ___________ _ !---····-··············································· .. ························································-·-······-················································································-··························-··············································-···-············--··········································--································' :""~~~.·,,,.,....,.,u;..•,;;,..,,..,.,.,n,.,_._,,., .• n,., . ..,.,_,,~,.,_,,.,nu,nno•n.nw•'""".--"'""'"'~''"''"u'•"'•"•"•"•'·"Un.-,.·,u1Y.·1nHU"N'N.",_ . ..,..,.,.,,...,M.,.,,.,,.,,.,.,.,.,V•_,,.,,.__,.,,.,.,.,.,."i. I Project Street Address: J)~ ! I I W rY\A((0{2)-(c fr}_ I j (Number) (Street) (Suite #) i I Building/Complex Name: ~~I~ -r~:~:;;·~~;:·~··:;·~:~·~·:;:::·~;:~ .. ~~--~~:~:::-, .. ·;~~-= .. =~::·~-:~;············! t ............................... ·--··-.. ··-----··-···--· .. · ... --.................... --.................. -...... -....... -................................... -................. 1~ Al-t· Nett 2tk:r Wm! Me<vS1kb l Applicant Information ~ l i ~ fl=..-1 .-vi I (architect, contr.i.ctor, owner/owner's rep} I 0' ~ ' ' ~ I l?n. I .I~.\/~ Mii. .1.:....-i-\1) I Contact Name: I ~ O-rv"~ ~ DVYC? I I ~ toH.ru!Wl'.& W\rtt Wl"5 !Address: i ' ~ ! 1i i'?l, ~ ~li{~o.--lb (!,, i City State: Zip: ~ ~ l ,; ~% \?1,1;!2..:S tlb>l\1 t'U217 -i Contact Name: (use additional sheet if necessj'HY) ! I~::::::===================================== ~~~E~;;.;;;:~~~-::::;:"---~I ! I hereby acknowledge that I have read this application, filled out I Building: ! in full the information required, completed an accurate plot plan, i i and state that all the information as required is correct. I agree to I Plumbing: $ ' ! comply with the information and plot plan, to comply with all Town ! ' ordinances and state laws, and to build this structure according i Electrical: $ to the town's zoning and subdivision codes, design review ap-i --------- proved, International Building and Residential Codes and other l Mechanical: ordinance th Town pp· able thereto. l lx I.rota!· $0 I Owner/Owner's Rep sent tiv· Signature (Required) !... ............ ~ ........................................................................................ -.... -.... -.... -.... -.... -.... -.... -.... -.. --.... -.... -.... -.... -.... -.... -.... -.... -....... ! 1 c::Wu~.) "~ -Ma~-w~hzte..r. L ...... -........................................ --·-·····-······ ..................................... -······--·· .. ··········-·······················-·············--·········· .... ..l Date ReceivriPD\~~©:::-::~:::::---::--:n w=--, -~-~--- MAY 2 'i 2016 @ For Office Use Only: U Fee Paid: __________________ _ Received From:-----------------TOWN OF VAIL Cash _________ Check# _______ _ CC; Visa / MC Last 4 CC # exp. date: ____ _ Authorization#-----------------