HomeMy WebLinkAboutB14-0374 Transmittal.pdfTOWNOF9
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 re issuance of the permit.
Application/Pennit #(s) infonnation applies
to: Attention:
Project Street Address: {:/: \I~\ \[~J.154, dQ I Gl: (
(Number) (Street) (Suite #)
~Revisions O Response to Correction Letter
o_attached copy of correction letter 0 Deferred Submittal QOther __________ _
Building/Complex Name: _1}v(..__"--"'fh..o(2_"""""--=_,_...;__\[~~--\ __ _ Description of Transmittal/ List of Changes, Items Attached: ..._ '
Applicant lnfonnation ~'€<\ Sct;--1) \[ A-h rlCr 1 b-v0
(architect, contractor, owner/owne~s rep
'i) -~ '::>. ' '
ContactName: ~{:) I '-¥':
Address: BJ <iSo tiC ( 8z..3
City \.{/t...-1 \ State: LO Zip: § lC:, S 8
Contact Name: _q.._~....:....:::;o'---~=--5;a..;;O~-'C .... ;,'-o-~_°l.....:.,_ __ _ (use additional sheet if necessary)
Contact Phone: __ 2-=~-=~...__ .... ~.__~'=--C ... '--~.,_,c;-~----Building Pennits:
o_ r-.... ~t \ '\ o 1 r :-Revised ADDITIONAL Valuations (Labor & Materials)
Contact E-Mail: __ ~_u_""'~---1-'\...;...,;,\1..J__,o=-V='\~=tC\.6 __ Vl..-...-..... k""-='W-'--'=-> (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 Buil · sidentia des and other Mechanical:
ordinance ow X Total:
Owner/
For Office Use Only:
Fee Paid:------------------
Received From: ----------------
Cash---------Check#-------
CC: Visa / MC Last 4 CC # exp. date: ____ _
Authorization#----------------
Date Received:
$ l £, S"e--o I
$ ( b~e-o-o I
$ { C> I !H'2-=f)
$ 2... er-e 0
$0 4o, -.;-ere