CASABLANCA EAST ARCHITECTURAL REVIEW COMMITTEE

REQUEST FOR MODIFICATION

CASABLANCA EAST HOMEOWNERS ASSOCIATION, INC.

I, _______________________________, hereby request approval by the Architectural Review Committee 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 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.
• Color samples, if applicable.

Use additional sheets if necessary.

Owner(s) Signature(s): __________________________ ___________________________________

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The above request for modification to Unit/Lot# ________ has been:  ¨    APPROVED

¨ APPROVED WITH THE FOLLOWING CHANGES   ¨ DISAPPROVED

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DATE:_____________CHAIRPERSON ARC:___________________________________________

DATE:_____________ BOARD OF DIRECTORS:________________________________________