Modification Request Form Co-Owner Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Complex* Building Number Unit Number Cell Phone*Home PhoneWork PhoneEmail* Requested Modification Request* Exterior Appearance Landscaping Structural Other Explanation of Modification*(A picture MUST BE INCLUDED with this form, i.e. door style, window, etc.)Pictures or additional documents Drop files here or Select files Accepted file types: jpg, png, gif, pdf, doc, docx, jpeg, Max. file size: 8 MB. Allowed file formats: jpg,png,gif,pdf,doc,docx. Maximum file size 8MB.Work to be performed by* (Please enter name of Contractor)Terms* I agree to the guidelines.1. All applicable codes and regulations will be followed and all necessary permits will be obtained at my expense. 2. I have read and understand all applicable sections of the Condominium Documents and agree to abide by them. 3. All maintenance and upkeep to the above modification will be performed at my expense and in a timely manner. 4. I understand that, should the Association or any legal regulatory agency require, at any time in the future, modifications to this variance, the modifications will be completed at my expense. 5. Any maintenance costs incurred by the Association as a result of this modification will be paid by me. 6. I understand that it is my responsibility to advise future assigns, purchasers or owners of this unit of their responsibility for same. 7. I understand that it is my responsibility to provide insurance for the above modification, and provide the Association a copy upon request. 8. I agree to hold harmless Stamper and Company, its agents its representatives and its employees, as well as the Association, for property damage or personal injury as a result of the above modification. 9. I hereby certify all of the above information is truthful and accurate. 10. I understand that the Association has the right to record a notice of modification in the chain of title to my unit. 11. I understand and agree that the Association has the right to maintain and repair Common Elements and if the modification requested impairs exercise of this right, the Association, is entitled, without liability to assigns, my susequent purchasers to me, to remove the modification as needed for maintenance and repairs to the Common Elements. 12. I agree that if I do not maintain the modification to protect community aesthetics, the Association can maintain or remove it ay my expense and without liability to assigns, my future purchasers to me. 13. If approved, the modification must be completed within one year of approval date. If the modification is not completed within the one year time period, then re-submission of a new Modification Request Form to the Board for consideration is necessary before you proceed with completion of the modification. 14. I understand and acknowledge that should the Association be required to commence legal action to enforce the terms of this Modification Request Form, I will be fully responsible to pay all court costs and attorney’s fees incurred by the Association in that enforcement action. Signature of Co-OwnerNameThis field is for validation purposes and should be left unchanged. Δ