DESIGN REVIEW BOARD
REQUEST FOR MODIFICATION
TIOGA COMMUNITY MANAGEMENT

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: _____________________________________________________________________

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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.
• The location of the modification on my property.
• Copy of the survey of my property.
• Material and color samples.
• $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

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DATE: ______________ CHAIRPERSON DRB: ________________________________

DATE: ______________ BOARD OF DIRECTORS: _____________________________