SHHA ARC Request

Signal Hill Homes Association

Request for Approval of Additions, Alterations, or Improvements
Please refer to your copy of the SHHA Restrictive covenants prior to completion of this form.

The Restrictive covenants are also available from the SHHA website (www.shhaburke.org) or by clicking here

This completed form should be submitted to the Board of Directors by clicking SUBMIT (below), or printed the ARC Request Here and mail to:

Signal Hill Homes Association
PO Box 2457
Springfield, VA 22152
Date of Request:*

MonthDayYear
Date
Applicant/ Homeowner Name:*

First NameLast Name
Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Expected Project Start Date*

MonthDayYear
Date
Expected Project Completion Date*

MonthDayYear
Date
Please describe the requested change (construction, addition, alteration, repair, replacement or improvement). Inclusion of drawings, plans, photos, and color / material samples will ensure that the review and approval process can be quickly completed.
Description of request:*
Upload any Supporting Files, Documents, or Picture Attachments Here:

Cancelof
Important Notes

1. I (applicant) understand that any construction or exterior alteration undertaken by me or on my behalf, prior to the submission and approval of this application is prohibited. I understand that I may be required to return the property to its original condition at my own expense if this application is disapproved wholly or in part, or if the construction or alterations are completed in a manner this is not consistent with this application. I may also be required to pay any legal expenses incurred by the Board of Directors towards resolving this application and its execution.

2. I (applicant) understand that members of the Board of Directors or Architectural Control Committee (ACC) are permitted to enter upon my property at any time for the purpose of inspecting the proposed project, its progress,
ant the completed project, and agree that such entry does not constitute a trespass.

3. I (applicant) understand that any approval is contingent upon construction or alterations being completed in a
workmanlike manner.

4. I (applicant) understand that it is my responsibility to ensure that all construction / alterations are completed in compliance with all applicable local and Fairfax County Building Codes, and Zoning Restrictions. I understand that I am responsible, and required to obtain applicable Building Permits, and scheduling any required inspections.

5. I (applicant) agree that all and only specified and approved construction/alterations will be completed within six months of the approval of this request.
Applicant Signature

Clear

For Office Use Only:
Date Received

MonthDayYear
Date
Date of Decision

MonthDayYear
Date
Decision:
Approve with Comments
Date Notification Sent to Home Owner

MonthDayYear
Date
Should be Empty:

Signal Hill Homes Association