Request for Review

ACC Request Form

Madison Hall Subdivision
Architectural Control Committee
Request for Review

Download as PDF 33.72 Kb 10/03/2010, 10:23

Name: _________________________________________________________
Date: ______/______ /20____
Address: ______________________________________________________
Home Telephone: _______ / _____________________________________

City/State/ZIP: Marietta. Georgia 30062
Home Facsimile: ________ / ____________________________________

Lot: ___________

Office Telephone: _______ / ___________________________________

Please provide the Architectural Control Committee ("ACC") with all information
necessary to evaluate the request thoroughly and quickly. Requests must include,
without limitation, the following information:

• Site plan (including all dimensions)
• Detailed description of request
• List of materials, if applicable
• Color chips, sample materials, if applicable
• Photographs, if applicable
• Other information as specifically required by the Committee

Description of Review Requested (attach additional pages as necessary:
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

Estimated Start Date: ______/______ /20____

Estimated Completion Date: ______/______ /20____

Please refer to the Madison Hall Covenants for necessary information regarding fences,
outdoor play equipment, structures, etc. The ACC will act within 30 days
of receipt of requests containing complete information.

I understand and agree that no work on this request shall commence
until written approval of the ACC has been received by me. I represent
and warrant that the requested changes strictly conform to the Madison Hall
Covenants and that these changes shall be made in strict conformance with
the Covenants. I understand that I am responsible for complying with
all Cobb County regulations.


Neither Madison Hall Homeowners Association, Inc., the Association Board of Directors,
or the Association Architectural Control Committee nor their respective members,
successors, assigns, agents, representatives, or employees shall be liable for
damages or otherwise to anyone requesting approval of an architectural alteration
by reason of mistake in judgment, negligence or nonfeasance, arising out of any
action with respect to any submission. The Architectural Review is directed toward review
and approval of site planning, appearance, and aesthetics. None of the foregoing
assumes any responsibility regarding design or construction, including without
limitation, the structural integrity, mechanical or electrical design, methods of
construction, or technical suitability of materials. I hereby release and covenant
not to sue all of the foregoing from/for any claims or damages regarding this request
or the approval or denial thereof.

Owner Signature: ________________________________
Date: ______/______ /20____

Owner Signature: ________________________________
Date:______/______ /20____

(Each person on property Title must sign.)


FOR ARCHITECTURAL CONTROL COMMITTEE USE:

Date Received:______/______ /20____

Approved Not Approved

by: _____________________________________ Committee Chairman

Date:_____/_____/20____

Conditions: ______________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

Comments:_______________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

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