HomeMy WebLinkAboutB14-0320 REV2 transmittal.pdfTOWN OF~ Department 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.
Application/Permit #(s) information applies
to: Attention: ~Revisions Q Response to Correction Letter
il_attached copy of correction letter 0 Deferred Submittal
B /l{ 03J.a
Project Street Address:
'112 Lto~s P.1J~1 lo4y
(Number) (Street) (Suite#)
Building/Complex Name: _B..._._f ~~~~~~t.Jq~-)-t,J_'-l~'~f~--
Applicant Information
(architect, contractor, owner/owner's rep)
Contact Name:J~ SQ~ Busse I (
Address: PO Box f;J.] 3
City £o{ 0a 'ol s state: CrO
Contact Name: j°'"~ f!.11 s st I '
Zip:
QOther __________ _
Description of Transmittal/ List of Changes, Items Attached:
f,,.tpl<Ac~ 9 ~s·a~s
(use additional sheet if necessary)
Contact Phone: 'f 10 30b qo93 Building Permits:
I\ + J. Revised ADDITIONAL Valuations (Labor & Materials)
Contact E-Mail: JA.SO~t:>J(A.1 (f\ (,Qt\~ f vpn \l"~'61'·l~DO NOT include original valuation)
I hereby acknowledge that I have read this application, filled out
in full the information required, completed an accurate plot plan,
and state that all the information as required is correct. I agree to
comply with the information and plot plan, to comply with all Town
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap-
prove lnternatio I Building nd Residential Codes and other
ordin n s oft wn app · able thereto.
x~+-l~-1-~=-~1--~~~~~~~-
Owner
For Office Use Only:
Fee Paid:------------------
Received From: ----------------
Cash _________ Check# ______ _
CC: Visa / MC Last 4 cc # _____ exp. date: ____ _
Authorization#----------------
Building: $
Plumbing: $
Electrical: $
Mechanical: $ if(J()(J.06
Total: $Q
Date Received:
JAN 06 2U15
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