Acc review form

Page 1

ARCHITECTURAL REVIEW COMMITTEE CONSENSUS Name of homeowner: ________________________________ Address:

Date____________

__________________________________________________

Nature of work to be done: (Please include detailed plans, paint samples, etc. to help the Committee arrive at a decision) _____________________________________________________________________ ____________________________________________________________________

____________________________________________________________________

________________________________________________________________________

--------------------------------------------------------------------------------------------------------Two Committee members’ signatures required for any action ____Approved ___Approved ____Disapproved (state reasons) ___Disapproved ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________

Name_________________________________Name____________________________ Signature__________________Date_______ Signature_________________Date____


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