HomeMy WebLinkAboutB15-0040 REV1 Transmittal.pdf ;: Department of Community Development
75 South Frontage Road
TOW OV. ,A „ Vail, CO 81657
IL
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: C)Revisions
�/ ��
r /1 � to Response to Correction Letter
.�_ I e E n attached copy of correction letter
C)Deferred Submittal
0 Other
Project Street Address:
I
17-5 ElcriAS ( V'ert` (
(Number) (Street) (Suite#)
Building/Complex Name: 6k_ 1 Description of Transmittal/List of Changes, Items Attached:
- 19(etee t Wie VO \UA kwe.
Applicant Information
rz5-Y4 is alb
(architect,contractor,owner/owner's rep)
Contact Name: Dt VAYel.CC L ` , T.er taw
Address:-60)C10
2 2
City V� State: eV Zip: - �llpD C�1/L r
Contact Name: a1 —V—C. CR) " (use additional sheet if necessary)
Contact Phone: c-1.'7 O 3 '7 Co t 2" BuildingPermits:...__._,...._.____._.
T � Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail: _ (DO NOT include original valuation) -
I hereby acknowledge that I have read this application,filled out €Building: $ 3) P-
I�'` U
in full the information required,completed an accurate plot plan,
and state that all the information as required is correct. I agree to i Plumbing: z $
comply with the information and plot plan,to comply with all Town
ordinances and state laws -rid to build this structure according Electrical: $
to the town's ;.ni. • ubdivision codes, design review ap-
proved,Inter l- io`(=1 B t •ing a . Residential Codes and other Mechanical: $
ordinances • the! ow -'p c..le thereto.
X Total: $0 6,boo .00
Owner/0 er's -ep -sentative Signature(Required)
Date Received:
For Office Use Only:
Fee Paid:
Received From:
Cash Check#
CC: Visa/MC Last 4 CC# exp.date:
Authorization#