HomeMy WebLinkAboutB14-0123 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: evisions
4)\ "l- b i 2- 171 7v-N g'e�' i---' Response to Correction Letter
Rattached co
of correction letter
C)Deferred Submittal
°Other
Project Street Address:r
(Number) (Street) r�1 (Suite#)
Building/Complex Name: W( Q, CU V 4c-V-- Description of Transmittal/List of Changes,Items Attached.
Applicant Information
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!, 't) --tipaNPC( )
(architect,contractor,owner/owner's rep)
Contact Name: 5IZ-C---
Address:
City State: _Zip:
Contact Name: SC r fuse additional sheet if necessary)
Contact Phone Building Permits:
Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: (DO NOT include original valuation)
I hereby acknowledge that I have read this application,filled out Building: $ I 6 0 0
in full the information required,completed an accurate plot plan,
and slate 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: $ 1I ri
()//��U
to the town's zoning and subdivision codes,design review ap-
proved.In ational Building and Residential Codes and other Mechanical: $ 17.1 V
ordina s o lh DA, Total- $ "T
Town a plicable thereto.
y ' J t i o o0
Owner/Owne eprese ative Signature(Required)
Date Received:
For Orrice Use Only.
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#