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HomeMy WebLinkAboutB16-0210.002 transmittal.pdf . . _.:,,, . ... 6 _ I Department of Community Development :°x' :r< 75 South Frontage Road TOWN n ;:.' • 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 f y G�I , GQ - Response to Correction Letter ` n attached copy of correction letter 0 Deferred Submittal )Other Project Street Address: 11 la 05 c' k- 1Yc, c-ccbk. Zc).91 WSJ r (Number) (Street) (Suite#) t ii_Building/Complex Name: or ,. .z1,'.,\ ;Yf\t\ z1AAI,b Description of TransmittaV List of Changes, Items Attached: _.._......- _ .._ ---0'\e, D\SLC kL:oick.I t GLro‘i 73 I Applicant Information (architect,contractor,owner/owner's rep) C ci i n C� - t.?. I Contact Name: )/, C • C.(")ft...- \) 0 C) t1j%n 1-2-C, . Address GA,, 38'4 / . n l; City .Rv C1\ State: 9 Zip: x z I Contact Name: \c}(\.' 1:)V-(cv1. / rc'.cr 1CC1 C- c-k =(use additional sheet if necessary) Contact Phone:b7v) 53 1 Building Permits: Revised ADDITIONAL Valuations (Labor&Materials) Contact E-Mail: korot Dv-(c,,, % (ro• ek:Y1�c, •CCW I(DO NOT include original valuation) i 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 3 Electrical: $ to the town's zoning and subdivision codes, design review ap- roved,International Building and Residential Codes and other I Mechanical: $ ordinances of the Town pplicable thereto. ordinances =X Me_i.Ccs \ \ft, ;Total: $0 1. ner/Owner's Representative Signature(Required) _..._....................._.................-_.._... Date Received: , E © rf _ W f- I _, v JUL 1 2016 For Office Use Only: J Fee Paid: - Received From: TOWN OF VAIL Cash Check# CC: Visa/MC Last 4 CC# exp.date: Authorization#