HomeMy WebLinkAboutB16-0347.001 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 reissuance of the permit. ,
t·····-························-················································-·······-···-······················································-··············-··-·········································-····-·········································································-·············-·······························-···································: l Application/Permit #(s) information applies 1
! to: Attention: ~evisions ! ~-~-~~~~:::_____ -~~------__ :~~:~~~~~~~-·=-_!
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! Building/Complex Name: 4L(2;1'-.e.. Tbw!k-wL&j e.> IV ~ Description of Transmittal/ List of Changes, Items Attached: l
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l Applicant Information ~ . I . · f ~J. f=\J:c..H-Pk.J:c. .:6 Z. -WJL k\ 71& lien~ \(architect, contractor, owner/owner's rep) * · I contact Name: r'lA,;~ (2., (_I~ eoa>~o-J >-z. o!-s-( frDD 1;'1'' STG£i. P'.d-c... -k>
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i Contact Name: !\&~ c..J&eL Z, t 7(u_s_e -a-;-dd-;:-iti;-;-. o-n-,al;-s7h-ee-;t-:-;if=-n-e-ce-=s-sfl-:-ry-.):------------
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~-! I hereby acknowledge that I have read this application, filled out j Building: $ ZS"""{QQ I in full the information required, completed an accurate plot plan, J l and state that all the information as required is correct. l agree to j Plumbing:
, comply with the information and plot plan, to comply with all Town l ! ordinances and state laws, and to build this structure according ! EI ctri r· l to the town's zoning and subdivision codes, design review ap-i e ca ·
j proved, International Building and Residential Codes and other ~Mechanical: l ordinances of the Town applicable the~ (
jX >~ ~ ~Total:
$~-------------
$. ______________ __
$. ________________ _
~Owner/Owner's Representative Signature (Required) ~--······--------······--··········--·····--·····: ................................................................................................................................. ,
i ~
L. .................................................................. -------------·······--·-············-·····--·······-···----·········----·-·································J Date Received:
For Office Use Only:
Fee Paid: __________________ _
Received From:-----------------
cash---------Check#--------------
CC: Visa 1 MC Last 4 CC # exp. date: _______ _
Authorization#-----------------
...:• I.J ·) ., 2016 vC.I ,_, .)
TOWN OF VAIL