HomeMy WebLinkAboutE16-0038 TRANSMITTAL.pdf fly �� d¢ Department of Community Development
;_ . - 75 South Frontage Road
�.,t Vail, CO 81657
Tiff (---.... C'-'-'
-� 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: - Attention: 0 Revisions
O I b— C i 2 Z. 0 Response to Correction Letter
❑ attached copy of correction letter
--6 & - o tj 0 .6 Deferred Submittal
; 0 Oiher
Project Street Address:
5t(c 5' 1kfriv6 a. ,A) . -.4-06)
I
(Number) (Street) ���� JJ 11 (Suite#)
o."
Building/Complex Name: & �!t1( Description of Transmittal/List of Changes, Items Attached:
Applicant Information f,
A Q-�Q 1-e a..(�S
(architect,contractor,owner/owner's rep)
)
Contact Name:
i q
Address: to
City State: Zip:
Contact Name: s(use additional sheet if necessary)
r Contact Phone: i Building Permits:
i Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: _(DO NOT include original valuation)
i
I hereby acknowledge that I have read this application,filled out i Building: $
in full the information required,completed an accurate plot plan,
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
i ordinances and state laws, and to build this structure according Electrical: $
to the town's zoning and subdivision codes, design review ap- `•
proved, International Building and Residential Codes and other f Mechanical: $
ordinances of the Town applicable thereto.
0
3
'Total; $
Owner/Owner's Representative Signature(Required) I
l l Date Received: :201:
For Office Use Only: %N �• r),)
Fee Paid: i
Received From:
Cash Check#. TOWN OF \i'AL.
CC: Visa/MC Last 4 CC# exp.date:
Authorization#