Date: _________________________ Lot No.: ______________________
Name:___________________________________________ Tel. No.:_________________________
Address:__________________________________________________________________________
I am requesting the Architectural Review Committee to approve the following:
__ Improvement __ Addition __ Repair
Nature of work to be performed:_______________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Location: _______________________________________ Dimensions: _______________________
Work to be performed by (contractor):__________________________________________________
Estimated Cost: Labor $_________________________ Materials $___________________________
Estimated Starting Date: ____________________ Estimated Completion Date: __________________
Adjacent Neighbors' Signatures:
Name: _______________________________________ Date: ________________________
Address:______________________________________
Name: _______________________________________ Date: ________________________
Address:______________________________________
Homeowners' Signatures:
Name: _______________________________________ Date: ________________________
Name: _______________________________________ Date: ________________________
The homeowners further understand, acknowledge and agree that any additions, improvements, repairs or alterations to their property are the sole responsibility of the homeowners (or their heirs) and that they shall be fully responsible for maintenance, repairs and upkeep on same.