HomeMy WebLinkAboutB14-0150 REV1 transmittal.pdf AWN Department of Community Development
• 75 South Frontage Road
TOWN OF VAIL L 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
S ` C3 I ,r�,ti, t ,eb e✓�� n attached copy of correction letter
C) Deferredflibmittal �
Other wr101 c�tt {�
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Project Street Address:
lc "riY-elV-
(Number) (Street) (Suite#)
Building/Complex Name: Description of Transmittal/List of Changes, Items Attached:
Applicant Information f(t(nkfdI al el,i•-• ci 170 Innen tom(z -r-CA4.-(40
41
�w1 rti� VVV4041 -mUJ k tokt�
(architect,contractor,owner/owner's rep)
Contact Name:1O Vis c,r,\ wl {{` -Lk,4-J wt
Address: a v C 4au4�1 C � �G13 RAh�ll�1 S IA 10 C!-
City Vc.. State: CO Zip: ���`�� S y tv-fa . tatn�a*w '‘< YMAfJ
Contact Name: ✓G��1�S t.c�C,G,��11 d `t� ) a ci���- vu
ll c3 J (use additional s eet if necessary) r
Contact Phone: 3V1` k��u� �1 rcttn- G-\t4 av . b i e (oA .4 C„r- �� A
Building Permits: ✓ I %An. ic9..h
� y Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: � ttl4 i faA1(4)A,`, (DO NOT include original valuation)
I hereby acknowledge that I have read this application,filled out Building:
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: $
to the town's zoning and subdivision codes, design review ap-
proved, International Building and Residential Codes and other Mechanical: $ ��
ordinances of Town applicable thereto.
X Total: $0 rr�
Owner/Owner's R re ntative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa!MC Last 4 CC# exp.date:
Authorization#