HomeMy WebLinkAboutB17-0114_Transmittal Open Hole_1508275320.pdf Department of Community Development
75 South Frontage Road
TV►41L Vail, CO 81657
OWN OF
Tel: 970.479.2139
www.vailgov.com
TRANSMITTAL FORM
Use this form when submitting additional information, changes& inspection reports for 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.
Submit this form only to: cdev_submittal@vailgov.com. Deliver paper plans to Community Develop-
ment or upload your revised/corrected plans to the appropriate project in ProjectDox,when requested.
Application/Permit#(s) information applies to: B17-0114
( ) Revisions (5 Response to Correction Letter attached copy of correction letter
( )Deferred Submittal H)Other Inspection
Project Street Address:
4367 Columbine Drive Description of Transmittal/List of Changes, Items Attached,
Indicate changed plan pages:
(Number) (Street) (Suite#)
Building/Complex Name: Please see uploaded'16-7-508.A(09-08-17)Ex.Ob.signed' Open Hole inspection from HP Kumar
Applicant Information
(architect,contractor, owner/owner's rep)
Contact Name: Steve Novy
Address: 65 N 4th St.
City Carbondale State: CO Zip: 81623 (use additional sheet if necessary)
Contact Name: Steve Novy
970 963 6689 Building Permits:
Contact Phone: Revised ADDITIONAL Valuations (Labor&Materials)
Contact E-Mail:
snovy@greenlinearchitects.com (DO NOT include original valuation)
Building: $
I hereby acknowledge that I have read this application,filled out
in full the information required,completed an accurate plot plan, Plumbing: $
and state that all the information as required is correct. I agree to
comply with the information and plot plan,to comply with all Town Electrical: $
ordinances and state laws, and to build this structure according
to the town's zoning and subdivision codes, design review ap- Mechanical: $
proved, International Building and Residential Codes and other
ordinances of the Town applicable thereto. Total: $
X
Owner/Owner's Representative Signature(Required)
Date Received:
1
21-Apr-2017