HomeMy WebLinkAboutB16-0426.001 application.pdfTfJWNOf~ 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: 7J /6 --CJ4-U ~ Oul Attention: filevisions
Project Street Addre~:/ (J .?A-Pv'4
(Suite#)
esponse to Correction Letter
ttached copy of correction letter
Q Deferred Submittal QOther __________ _
(Number) (Street) J
Building/Complex Name: ___ .... fv'_ .... ~..._ff..__ ______ i Description of Transmittal/ List of Changes, Items Attached:
· Applicant Information
1 (architect, contractor, owner/owner's rep)
Contact Name: __ f,~£-A'_f 0._~ ___ tfJ_P_& ___ _
Address: Z--~? 0 61151rv60 /J'W
City J/81 L-State: VJ Zip: 1] / b ) 1--
. Contact Name: -----..-------------
'contact Phone: _.(......,-9,........._ro_.....)_5_f+--()-.--_V_rt'_,6"-----
tftl J!1d1 -(J11. t M r n L Q) J m ii. I o UJl'h Contact E-Mail:
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
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap-
proved, International Building a d Residential Codes and other
ordinances of the Town app · ble reto.
,X _____ __,~---------
. Owner/Owner's Represen tive Signature (Required)
Re-uriArvt't ttJlrt'{)J""' 3 wef ba/'!1",re."'-
aclc( t"n j lo AJ e b t? arti... A. ut±
/>i "htv.4e_ t !'1fh/I/' 4~J--~
(use additional sheet if necessary)
Building Permits:
Revised ADDITIONAL Valuations (Labor & Materials)
·(DO NOT include original valuation)
Building: $ } ( ( ft;o
: Plumbing: $ t.100
I
Electrical: $
, Mechanical: $ (, tSl»
' c:J2,fo8 I $0 Total: (
Date Received:
,<n_( ~-I~~<; 5 F c.-~
11
fV'-9--0 l-r rz._,(J; .'?.,
.-----------------------. I Lt o< , /) l V""'~ 1 f fiEcEIVED
For Office Use Only: !::A--') (
Fee Paid: --':J I O 5 B /
Received From:------------\:: "L-. ~AR 0 6 2017
Cash _________ Check#_______ .~·
Cc V. / c cc# d cv Town of Va1·1 : 1sa M Last 4 exp. ate: ___ _
Authorization#----------------