Date: _______________ Time: _____________

Name: ___________________________ Unit #: _____ Telephone: _________________________

Email: ___________________________________________________________ 

Owner? ___  Yes  /  No       If Tenant, please list Owner Name and Telephone Contact:

__________________________________________________________________________________

REQUEST: (Please be as specific as possible.  Please use the opposite side if more space is needed)

__________________________________________________________________________________

__________________________________________________________________________________

By my signature below, I understand that until this application has been approved, that I am not permitted to commence any requested action.  Failing to adhere to this policy may result in the denial of the request, a penalty, or both.

Signature of Applicant: _______________________________________      Date: ________________

BOARD ACTION

____ Unqualified Approval             Qualified Approval (See Qualifications Below)             Denied Generally

          Denied for Lack of Specificity.  Applicant may re-apply supplying more information to support the request

If your application is approved, you are only permitted those items which you requested above, except as limited below.

____________________________________________________________________________________

____________________________________________________________________________________

Music Allowed  Yes / No        Deposit Required:  _______   Security to be provided at Owner's Expense  Yes  / No

Signature ___________________________________________________   Date: ________________