Mayfair in Tampa Palms

ADMC Form

Jul 10, 2006

TAMPA PALMS NORTH OWNERS?’ ASSOCIATION, INC.
10012 N. Dale Mabry Highway, Suite 223, Tampa, FL 33618
Telephone# - 813-963-6400 Fax number - 813-964-8582
Community Manager - Susan Thomas, CMCA

ATTENTION: ARCHITECTURAL DESIGN AND MODIFICATIONS COMMITTEE (ADMC)

DATE:_______________________ Is this application a re-submittal of a previous application? Yes / No (circle one)
The undersigned owner seeks approval of the Committee as follows (circle all that apply):

Pool/Spa Screen Enclosure Solar Heating Panels Satellite Dish Fence

Landscaping Painting Storm Shutters New Construction Other

Narrative Description of Additions/Alterations:_____________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________
(Continue on Additional Sheet if Necessary)

INCLUDED (please circle all that apply):
Original Paint chips
Copy of Official Lot Survey Specifications for Alteration or Color Swatches Material Sample

Brochures Photographs Drawings Note: Please indicate on lot survey where alterations will be located on
Property.

The undersigned property owner hereby acknowledges and agrees that the undersigned shall be solely responsible for determining whether the improvements, alterations or additions described herein comply with all applicable laws, rules and regulations, code, and ordinances: including, without limitation, zoning ordinances, subdivision regulations, and building codes. The ACC shall have no liability or obligation to determine whether such improvements, alterations and additions comply with any such laws, rules, regulations, codes or ordinances.

SIGNATURE OF OWNER ______________________________________________________________

PRINTED NAME_______________________________________________________________________

STREET ADDRESS__________________________________NEIGHBORHOOD___________________

LOT & BLOCK NUMBERS ______________________________________________________________

TELEPHONE (H)_________________________________(W)___________________________________

PLEASE ALLOW UP TO 45 DAYS TO RECEIVE AN APPROVAL FROM THE ADMC COMMITTEE


ACTION OF THE COMMITTEE

________ RECOMMEND APPROVAL WITH CONDITIONS: _________________________________________
_____________________________________________________________________________________

________ REQUEST DENIED FOR THE FOLLOWING REASON:______________________________________
_____________________________________________________________________________________
________________ ______________________________________
DATE CHAIRPERSON, ADMC
ADMC Representatives visit the property prior to their committee meetings to conduct a visible inspection as they review each application.