Inlet Cove Homeowners Association

INLET COVE HOMEOWNERS ASSOCIATION ARCHITECTURAL MODIFICATION APPLICATION

Please fully complete, sign, and submit this form with a copy of an official plat and any necessary documentation via mail or FAX to: Inlet Cove Homeowners Association ATTN: Covenants Committee Service First Management & Consulting, Inc. 12084 Cadet Court Manassas, Virginia 20109 FAX 703-392-5039 A copy of the application reflecting action taken by the Covenants Committee on behalf of the Homeowners Association Board of Directors will be returned to you for your records. Modifications must not commence without approval by the Homeowners Association and must be in accordance with the Declaration of Covenants, Conditions, and Restrictions regarding the property for which the application is submitted.

NAME OF OWNER(S): ______

INLET COVE ADDRESS: ______

TELEPHONE NUMBERS: (H)______(W)______

EMAIL ADDRESS: ______

DATE ON WHICH MODIFICATION WILL COMMENCE: ______

TYPE OF MODIFICATION (Please check all that apply): _____ Deck _____Fence _____Patio _____Satellite Dish _____Landscaping _____ Antenna _____Other (please specify) ______

FULL DESCRIPTION AND/OR DIAGRAM OF MODIFICATION REQUESTED: ______

1 ______NEIGHBORS’ SIGNATURES (The signatures of all adjacent property owners are required. Their signatures indicate awareness of intent and do not constitute approval or disapproval.):

NAME: ______ADDRESS:______SIGNATURE: ______

OWNER’S ACKNOWLEDGEMENT: I/we understand that: 1. Material herein contained will represent alterations that comply with the zoning and building codes of Fairfax County to which the above property is subject. Further, nothing herein contained will be construed as a waiver or modification of such ordinances. The owner is responsible for obtaining the necessary permits prior to commencement of construction. 2. No work will commence until the owner has received written approval from the Homeowners Association. Any construction or exterior alteration before approval of this application is not allowed, and if alterations are made, I/we may be required to return the property to its former condition at my/our own expense, and that I/we may be required to pay all legal expenses incurred. 3. Approval is contingent upon all work being completed in a professional manner and any alteration or modification that is not finished in such a manner and in accordance with the approval granted herein may be required to be removed or repaired at the homeowner’s risk and expense, including any legal fees required to enforce this acknowledgement. Members of the Covenants Committee, the Board of Directors, or management agent may make routine inspections. Approval, if granted is solely meant as a waiver from the restrictions in the Declaration and is not meant to comment or advise on the fitness or safety of any proposed alteration or modification. 4. This request is subject to restrictions by the Declaration and a review process as established by the Board of Directors. Any variation from the original

2 application must be resubmitted for approval. The Covenants Committee or the Board will return a copy of this request to me/us after review.

5. I/we acknowledge and agree that I/we will be solely liable for any claims, including with limitation, claims for property damage or personal injury that result from the requested addition or modification. I/we hereby indemnify the Association, Board of Directors, Covenants Committee, and management company from and against any and all such claims. Moreover, I/we accept responsibility for all maintenance, repair, and upkeep of said addition or modification.

______SIGNATURE OF OWNER DATE

ACTION BY THE HOMEOWNERS ASSOCIATION

DATE RECEIVED: ______

REQUIRED ELEMENTS INCLUDED: _____Detailed description or diagram _____Copy of official plat with location of modification indicated _____Signatures of neighbors _____Signature of owner(s)

______APPROVED AS SUBMITTED ON ______

______DENIED ON ______

______APPROVED WITH THE FOLLOWING CONDITIONS ON ______

______

3 ______

______AUTHORIZED SIGNATURE DATE