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Modification Request Form,
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Modification Request Form
.
DESIGN REVIEW BOARD
REQUEST FOR MODIFICATION
TOWN OF TIOGA COMMUNITY ASSOCIATION, INC.
Please allow ten (10) business days for review.
I, _________________________, hereby request approval by the Design Review Board
for the modification shown below to
Unit/Lot_____ located at:
_____________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Upon approval of my request for this modification, I/We will assume all
liability for any damage incurred as a result of this modification as well as
any additional maintenance costs that may be incurred. I also agree to obtain
any permits that may be required by any and all governmental agencies for this
modification. Attached please find two (2) copies of the following additional
information:
-
A sketch, including the dimensions, of the proposed modifications.
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The location of the modification on my property.
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Copy of the survey of my property.
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Material and color samples.
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$75.00 check payable to Tioga Community Management (DRB may
refund the fee as applicable)
Use additional sheets if necessary.
Owner(s) Signature(s): _____________________________
_____________________________
The above request for modification to Unit/Lot# ________ has been: ( )
APPROVED
( ) APPROVED WITH THE FOLLOWING CHANGES
( ) RETURN FOR SPECIAL MODIFICATION
________________________________________________________________________
________________________________________________________________________
DATE: ______________ CHAIRPERSON DRB: ________________________________
DATE: ______________ BOARD OF DIRECTORS: ____________________________