Item 6L - HOA formCARILLON HOMEOWNER'S ASSOCIATION
ARCHITECTURAL CONTROL COMMITTEE IMPROVEMENT REQUEST FORM
In accordance with the recorded covenants, conditions and restrictions of the association, and in order to
protect each individual owner's rights and values, it is required that any owner who is considering exterior
modification of his/her deeded property submit the following to the Architectural Control Committeerip for to
initiating work on the planned improvements:
(1) A completed Improvement Request Form (ONE EXTERIOR MODIFICATION PER REQUEST
FORM. Multiple modifications submitted on one form will be rejected).
(2) Complete and detailed building plans, material listing and specifications
(3) A property site/survey plans showing the location of the proposed improvement.
FAILURE TO SUBMIT THE REQUESTED ATTACHMENTS (ITEMS 1, 2 & 3) PRIOR TO CONSTRUCTION MAY
RESULT IN DENIAL OF YOUR REQUEST FOR IMPROVEMENT. If any change is made without approval, the
Committee has the right to tell the homeowner to remove the improvement from his/her property. Any
homeowner considering any exterior improvement to his/her property is urged to review the recorded deed
restrictions prior to initial request.
PLEASE PRINT THE FOLLOWING INFORMATION:
Owner Name: Alan & Allis Romero
Address: 833 Lake Carillon Lane, Southlake, Texas 76092
Home Phone: (213) 400-6809 Best Time to Call:
Email Address: ALLIS.CHO@GMAIL.COM
BRIEFLY DESCRIBE THE IMPROVEMENT THAT YOU PROPOSE:
Roof mounted solar system
LOCATION OF IMPROVEMENT (CHECK ACTUAL AREAS THAT APPLY):
❑ Front of dwelling
❑ Side of dwelling
❑ Garage
❑ Other (Describe)
❑ Back of dwelling
® Roof of dwelling
❑ Patio
MATERIAL TO BE USED FOR THE IMPROVEMENT (CHECK APPLICABLE ITEMS):
❑ Brick (Color)
❑ Wood (Type/Color)
❑ Paint (Color)
❑ Other (Explain)
❑ Cement /Stucco
❑ Electric
❑ Stain
❑ Glass
ADDITIONAL INFORMATION FOR THE IMPROVEMENT:
Applicable deed restrictions read? YES / NO
Will this project require fence removal? YES / NO
Building permit applied for if necessary? YES / NO / NOT APPLICABLE
Will project be visible from the street? YES / NO
Consent is required from any adjacent properties that will be most affected and/or have a view of your
proposed change. Should one of your neighbors disapprove, please indicate with the reason for their
disapproval noted. Their signatures indicate an awareness of your intent and do not constitute or indicate
approvaa isap,proval by the committee. , y
(Neighbor's Signature / Address / Phone Number)
(NeigFSbor's Signature / Address / Phone Number)
(Neig'hbor's Signature / Address / Phone Number)
(Neighbor's Signature / Address / Phone Number)
1 understand that the Architectural Control Committee and the Board of Directors will act on this request within 30
days of receipt and contact me in writing regarding their decision. 1 agree not to begin property improvement without
written approval from the Architectural Control Committee and the Board of Directors. 1 understand that all construction
must meet City and County code requirements, and that the Architectural Control Committee approvals do not override
the City or County codes, but rather are intended to work with t e
1,5
Owner's Printed Name Sig ure f,.�-� Date
ti
Owner's Printed Name Signature Date
Construction Start Date
Estimated Completion Date
Return this completed form and attachments to Associa-PMG North Texas,
9001 Airport Freeway, Suite 4S0, North Richland Hills, Texas 76180
Email: NTXACC@associa.us
(For ACC Committee Use Only)
ACC Decision: APPROVED / APPROVED WITH STIPULATIONS / DISAPPROVED / DISAPPROVED FOR MORE
INFORMATION
ACC Chairperson or Representative:
Rationale: