HomeMy WebLinkAboutB13-0239 REV3 transmittal .�
Department of Community Development
.� 75 South Frontage Road
TOWN DF VAiL � vai�, CO 81657
_� Tel: 970.479.2128
www.vailgov.com
Development Review Coordinator
TRANSMITTAL F�RM
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#(sj information applies
to: Attention: �Revisions
B13-0239 Bidg. Dept. 1�Response to Correction Letter
�attached copy of correction letter
DRB130402 �(�� Q Deferred Submittal
�otner
Project Street Address: _ _
5148 Gore Circle Drive
(Number) (Street) (Suite#)
Building/Complex Name: pescnption of TransmittaU List of Changes, Items Attached:
See attached drawings and DRB approval for design change
Applicant Information
to the window well.
(architect,contractor,owner/owner's rep)
Contact Name: Ankerholz Inc.
Address: P.O. Box 296
City Avon State: C� Zip: 8T620
Contact Name: Ankerholz Inc.
(use additional sheet if necessary)
Contact Phone: 979-949-6341 - - -
Building Permits:
Contact E-Mail: ankerholzinc@yahoo.com Revised ADDITIONAL Valuations(Labor 8�Materials)
(DO NOT include original valuation)
I hereby acknowledge that� have read this application,filled out Building: �0-
in full the information required,completed an accurate plot plan,
and state that all the information as required is correct. I agree to Plumbing: �0-
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, Intemational Building and Residential Codes and other Mechanical: $�-
ordinances of the Town ap lic le thereto.
X -- cr� To'•. ,. �0
Owner/Owner's Representative Sig�ature(Required)
Date Received:
F'or O�ce Use Only: D � � � � M �
Fee Paid:
Received From: t+
Cash Check# ���D �- 1 2013
CC: Visa/MC Last 4 CC# exp,date: �Ci� J �1'?}�j"
Authorization#
TOWN OF VAIL