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HomeMy WebLinkAboutB15-0038 REV1.pdf Department of Community Development 75 South Frontage Road TOWN fl VAIL4111111) 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: 0 Revisions 1 5. Q© 3.S cosra Y0 Response to Correction Letter rJ n attached copy of correction letter 0 Deferred Submittal Other Cid 1 S. Project Street Address: 1 3 '(Number) (Street) � ` L Suite# �� o ' ( ) Building/Complex Name: 4...RS1N=V, Description of Transmittal/List of Chan es, Items Attached: Applicant Information ;'� SDS (architect, contractor,owner/owner's rep) w� 14S iI I Contact Name: fY'Gl— 7 �D �, Address:c �K Cityrc2�1, SrtatetQ' Zipe‘S Contact Name: p(`c & ' c d 1 (use additional sheet if necessary) Contact Phone: Building Permits: \\ Revised ADDITIONAL Valuations(Labor&Materials) C'� � 11,, Contact E Mail: `�\QLi,\••ciS •G4*-+ (DO NOT include original valuation) I hereby acknowledge that I have read this application,filled out Building: $ 904!:,.moo tin 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 I Electrical: $ to the town's zoning and subdivision codes, design review ap- i 1 prove, - national Building and Residential Codes and other Mechanical: $ o : nances if the Town applicable thereto. r cr� X Total: lOwner/O -r's Representative Signature(Required) Date Received: For Office Use Only: Fee Paid: Received From: Cash Check# CC: Visa/MC Last 4 CC# exp.date: Authorization#