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Request #____________

HOMEOWNER APPLICATION FOR ADDITION/ALTERATION/CHANGE


TO THE EXTERIOR OF ANY LOT, HOME OR ENVIRONS
Instructions: Complete and attach all necessary exhibits. Mail to: Architectural Review Committee, Fox Mill Estates Homes
Association, PO Box 710842, Oak Hill, Virginia 20171-0842
NAME: __________________________________________________________
ADDRESS: ____________________________________ PHONE: ___________________
E-MAIL ADDRESS: _________________________________________________________________
MAILING ADDRESS, IF DIFFERENT FROM ABOVE:
______________________________________________________________________________________
Please provide details by sketches, drawings, clippings, pictures, catalog, illustrations, and other data on attached sheets. Describe
and give full details (and/or attach exhibits) of your exterior change, estimated start and completion dates. Show location of
proposed change by submitting a marked copy of the site plan of your lot.

________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
The ARC requests, for the purposes of information only, the acknowledgement of owners who are most affected because they are
immediately adjacent to and/or have a view of the change that is requested. Comments from and/or notifications of neighboring
homeowners who are directly affected by the proposed project should be submitted. By signing below it in no way indicates the adjacent
owners approval, only ones acknowledgement.
.

Name: __________________________
Signature: _______________________
Address: ________________________

Name: ___________________________
Signature: ________________________
Address: _________________________

Name: __________________________
Signature: _______________________
Address: ________________________

Name: ___________________________
Signature: ________________________
Address: _________________________

Owners Signature: ______________________________________ Date: _____________


Owners Signature: ______________________________________Date: _____________

RECITALS
Approval of this application does not relieve the owner of the obligation to comply with the building and zoning codes of Fairfax County to which the
property is subject and to secure required permits.
I understand that any construction or exterior alteration undertaken by me or in my behalf before approval of this application is not allowed and that if
alterations are made, I may be required to return the property to its former condition at my expense if this application is disapproved wholly or in part.
I agree that members of the Architectural Review Committee may enter upon my property, upon prior request, for the purpose of inspecting the proposed
project, the project in progress, and the completed project, and that such entry shall not constitute a trespass.
I understand that any approval is contingent upon construction or alterations being completed in a workmanlike manner.
The Architectural Review Committee decision will be made within 30 days of receipt by the ARC of the complete application. The homeowner understands
and agrees that no work shall be commenced until written approval from the Fox Mill Estates Homes Association has been received and provisions of the
covenants and bylaws are satisfied. The owner also understand changes implemented without an appropriate application are in violation of the guidelines,
and the Board may require such changes to be removed or altered to conform with the guidelines at the owners expense.
ARC-1

REV 07/2004

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