HomeMy WebLinkAboutB14-0103 REV1 Transmittal.pdf Department of Community Development
75 South Frontage Road
°.\-)
TOWN OF VAIL 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: Attention: Revisions
/ 0 Response to Correction Letter
1�J/��s C'1 ��� Lrn.1 C CG./nOk' l n attached copy of correction letter
tt-
,/ 0 Deferred Submittal
6/q — D/ir3 (Q Other
Project Street Address:
/65a Pog'U,/'e/r66- 0-0 . ..i/6,
(Number) (Street) (Suite#)
r
Building/Complex Name: /gid9.e ed-n /ds Description of Transmittal/List of Changes, Items Attached:
Applicant Information
(architect,contractor,owner/owner's rep)
Contact Name: j4t. c f4 f/i
Address: //(13 cael/o/ . SI. Svin. zft
City EC Ie.-- State: lits Zip: 13 7/
Contact Name: (use additional sheet if necessary)
Contact Phone: 714, 39'00 XC T' Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: al-id c_ .(,ScS7 e.--/ (DO NOT include original valuation)
I hereby acknowledge that I have read this application,filled out Building: $ O
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: $ G7
to the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Mechanical: $ b
ordinances of the Town applicable thereto.
X - �> Total: $0
Owner/Owner's Representative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#