HomeMy WebLinkAboutB16-0491.001 transmittal.pdf Department of Community Development
75 South Frontage Road
TOWN OF VAIL I- 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: Atte_tion:
�I � - 'Revisions
l 7[6,1A
'I�Qrl�� ( Response to Correction Letter
1 �-lJ n attached copy of correction letter
O Deferred Submittal
0 Other
Project Street Address:
Ii
3 60R Cv ee(-z-- {.
(Number) (Street) \ (Suite#)
/ __.
Building/Complex Name: �0 CL I �`��I �� V �t�S Description of Transmittal/List of Changes, Items Attached:
Applicant Information �
Vel.- VeJ
(architect,contractor,owner/owner's rep) ,�,
Contact Name:, "t'/'A �1�1\ 1s� ASS 6 Cr r ---( :1 I�� L & 1
Address:
City Sttate: Zip:
Contact Name: Sa V( (use additional sheet if necessary)
Contact Phone: q'TO 501 .57"Tic, Building Permits:
1 61��S(e S ` Revised ADDITIONAL Valuations(Labor&Materials)
Contact E-Mail: wild 1 A • �-1^^ (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,Ig1erpational Building and Residential Codes and other Mechanical: $
ordi nces ofthe Town applicable thereto.
X Total: $0
Owner/O n '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#