Property Owner *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I would like to start the project on: *

MM

DD

YYYY

Estimated completion date *

MM

DD

YYYY

Location of improvements (check all that apply) *

Front of House

Back of House

Garage

Driveway

Patio

Side of House

Sidewalk

Roof

Check Improvements to be made *

Installation of fences or walls

Swimming Pool

Patio or Arbor

Other

CERTIFICATIONS AND AGREEMENTS: *

Homeowner certifies that all materials submitted for this application are true and correct. Homeowner understands and agrees that no work be performed prior to or in deviation from the terms of a permit approved by the Architectural Control Committee. Homeowner will assume responsibility for all future maintenance of this addition or improvement. Homeowner acknowledges that their Association dues account is current. In the event that the Homeowner fails to comply with the ACC Approved requirements, the ACC may require, amongst other things, the Owner to make the necessary corrections to bring the modification into compliance or to restore the modification back to the original condition. These changes will be done at the Homeowner’s sole expense. It cannot be stressed enough the importance of complying with the stated guidelines provided by the Association for these particular items on this pre-approved form. These modifications like any other will be reviewed and scrutinized by the Architectural Control Committee, the Board of Directors and the management agent/company. Note: If work is not completed by Estimate Completion Date then please contact the HOA Board for an extension.

I agree