HomeMy WebLinkAboutB16-0166.001 transmittal.pdfDepartment 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 pfanning 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
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/ Project street Address: j
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'I (~umber) (Street) (Suite #} i ................................................................................................................................................................................... !
~ . j I Building/Complex Name: L ~ yL t'-l! u-'-> -e..... .~ Description of Transmittal/ Ust of Changes, [terns Attached: l
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l 3 ,, -· --. ,., I ' L .;.. i . · ~ · r" > P.,. 1 • o n ly N-f L,_, c.. • 't---oVL:L ..-_, •'' "-,,. a.A ; (architect, contractor, owner/owner's rep) ~ o
; fi r{; s 1; m«. ~ f\=-~ Ju ;1-dL Pa ;_,-e., r/a.t.f..'-r-1 Contact Name: B:U e. h. 57 J. ,e( u l l ,I
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! ~ S' II i j) --. )-1· i !contact Name.· ~ ~ ..:::.'"··-I v·<-.,L--L (.' <;.o ... r·" ~ J•!t.<. ~-Y" ' l ,~ () l
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l Contact Phone: 9 ? l --7 7 <f-d 0 Y f . ,..B~li.di~g--P~;;;;jf;: ---=-~~ .... '. .. == ............ ~=, ................................................................... )
J . , / d · . /) . . . l Revised ADDITIONAL Valuations (Labor & Materials) i I Contact E-Mail: 5 jd. u..LL <; ?< c LL-'7 •UL f'Ltt "'-l, · '.'.> (~ ,J'1 H "-·L~e .-;~ j (DO NOT include original valuation) j
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! l hereby acknowledge that I have read this application, filled out l. Building: $ l
in full the information required, completed an accurate plot plan, j [
and state that all the information as required is correct. I agree to l Plumbing: $ i
comply with the information and plot plan, to comply with all Town i l ; l ordinances and state laws, and to build this structure according , El tr' r $ '
to the town's zoning and subdivision codes, design review ap-j ec ica: ',,_.:',,,_~:,,; , proved, International Building and Residential Codes and other I Mechanical: $ j ordina_nesJ7fhe To'fl:Yapplicable the. reto. ; ·----------
! X iL(.LLi-e--!r/ ;;t?-!:Total: $._o _______ _
! Own:r;owner>; Represef!f:ative Signature (Required) l i···········-··-······························-·······································--······-·····-·······-····-·-···-···-·······-· .. ····-·-···-···-·-···············-··'
} t ..................... , ................... ____________________________________________________________________________ , _____________________________________________ J Date Received:
For Office Use Only:
Fee Paid; ___________________ _
Received From:------------------
Cash __________ Check#--------
TOWN OF VAIL __ J
CC: Visa / MC Last 4 CC# exp. date: ____ _