HomeMy WebLinkAboutB14-0477 REV1 Transmital.pdf Department of Community Development
75 South Frontage Road
TO OF VA IL Val, 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 pour minimum building review
fee of$110.will be charged upon reissuance of the permit.
•
AppllcationIPermit#(s)Information appi[es
to: Attention; Revisions
- �-� Response to Correction Lotter
•
attached copy of correction !attar
Deferred Submittal •
0 Other -_
Project Street Address:
,c,742i,ATIg es R,L •
(Number) (Street) (Suite#)
ui[dinglOornpiex Name: {, - Description of Transmittal!List of Changes, Items Attached;
•Applicant Information • PCM‘me. rr + it c o E k.(;_ S
o F
(architect, contractor, owner/owner's rep) 6
Contact Name:B: Re � u' 1 1 — IIF 4 {
Address: O •_- �cc S i +. nes , c; C_-01x14-i'W
l'--- is ell r ,
City EV S V01 State: GO Zip: .( e21 - - -
Contact Name; T'Uci,� - (use addiional sheet it necessary) . . . -
Contact Phone: R10 T6�C+14 _ Building Permits:
Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: CruuigEVA Q A41SCF /i4 tu (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 ail the information as required is correct. I agree to Plumbing; 5
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: S ,o +-
ordinances of the Town applicable thereto. — --
X Total; 5°
OwnerlOwntskRepresentative Signature(Required)
Date Received:
rm.< lice TIRE Only;
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC !Last 4 CC# oxp.date'
Authorization 4