Ivey Chase



Ivey Chase Homeowners Association
Application for modification
Architectural Control Committee: (ACC)
FAX TO DALE STEIN @ 770-945-0408

Date: _____________________________
Owner: _____________________________
Lot #: ______________________________
Phone: ______________________________

Contractor Name:______________________
Phone: ______________________________

Description of Improvement Proposed:

All Submittals must be accompanied with the following:
1. Architectural drawing and/ or pictures.
2. Property survey showing proposed improvements.
3. Description of materials.
4. Paint samples, if applicable

Proposed start date :______________________
Proposed completion date:_________________
* NOTE: allow for 30 Days after submission. Please send completed form to:
Community Management Associates, Inc
c/o Ivey Chase HOA
1465 Northside Drive, Suite 128
Atlanta, GA 30318

Important Notice:
For your protection, inquire with the City and/or County about permit requirements before starting any work on said property involving new construction, alterations, modifications or additions.

** Signature of Homeowner(s) Required**
Neither the Declarant , the Association, the ACC, the Board, nor the Officers, Directors, Members, Employees, nor the agents of any of them shall be liable in damages to anyone submitting plans and specifications to any of them for approval, or to any owner of property affected by the declaration by reason of mistake in judgment, negligence, or disapproval or failure to approve or disapprove any such plans or specifications; nor shall any of them assume Liability or responsibility for any defect in any structure constructed from any such plans and specifications.

The undersigned owner(s) hereby acknowledges that he or she is responsible for complying with any third party easements setbacks, buffers and any other county requirements. Any approval of plans and specifications shall not entitle improvements to be built if otherwise prohibited by any third party easements or other County requirements.

Approval of any such structure by the ACC is in no way a certification that the structure has been built in accordance with any Governmental rule or that the structure has complies with sound building practice or design.

Homeowner(s) acknowledge(s) that s/he has read the entirety of this form.

Printed Name:__________________________

Printed Name:__________________________

Date received:__________________________

Posted by touchstone on 05/19/2007
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