ARC Improvement Form

Architectural Review Committee
Request for Property Improvement
(Submit to any member on the Architectural Review Committee) Requestor's Name:
Date:
Address:
City:
State:
Zip:
Telephone No.:
Lot Number (if known):
Nature of Request:
Drawing Attached? Yes No
Special Conditions:
Architectural Review Committee Signatures
Approved Disapproved
Dave Black beaverbigdave@icloud.com ___________________________ _________ ___________
Gerry Austin millsaustin@wavecable.com ________________________ _________ ___________
Rick Chapman rkmcchapman@wavecable.com ______________________ _________ ___________
P.O. Box 763 - Port Orchard - Washington - 98366
www.coniferpark6.com
(Last updated 7/28/2015)