North Crossing Community Association

ARCHITECTURAL REQUEST APPLICATION

Name: __________________________ Property Address: ______________________________

Owner's Mailing Address: ___________________________________

Day Phone: _______________ Evening Phone: _______________

DESCRIPTION OF PROPOSED EXTERIOR CHANGE OR ALTERATION. Include as much detail as possible including photograph or drawing, materials to be used, style, and color and other helpful information. Provide a site plan or survey. If the work is to be performed by someone other than the Homeowner, please provide the contractor's name and telephone number if known. Attach a separate sheet if more space is needed.

Estimated beginning date: _____________ Projected completion date: ______________

I understand that approval does not relieve me of the responsibility for obtaining any and all necessary Building Permits, variances, and/or observing all local zoning ordinances. If approved by the Architectural Guidelines Committee (AGC) I agree to make the changes under the terms and conditions as specified in the approval letter. All improvements must be on my property or property lines. If any portion of the Association property is disturbed or damaged by either myself or my contractor, then I agree to be responsible for and to restore the common elements to their original condition(s).

Signature of Applicant: ________________________ Date: ____________

PLEASE RETURN TO: North Crossing Community Association

c/o Clagett Enterprises, Inc.

20 West Third Street

Frederick, MD 21701

Architectural Review Committee Consensus Action (Indicated by the ARC Chairperson's Signature):

Approved As Is: __________________________________  Date________________

AGC Chairperson

Approved With Conditions ( See Attached ARC Letter For Conditions)

_________________________________ Date________________

AGC Chairperson

Not Approved (See Attached ARC Letter For Explanation)

__________________________________ Date________________

AGC Chairperson