Owner ARC Application

Grange Residential Association, Inc. Architectural Review Committee Owner Modification Request Application
Owner Name(s)*
(Applicant(s) must be the record Owner(s) of the Lot for which proposed changes to the Dwelling or other Improvements on the Lot in this form apply. No persons other than the Lot Owners may submit a request form.)
Lot Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Lot #:*
Block #:*
Section:*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Name and Contact Information for Owner's Builder, Contractor or Designee:*
Pursuant to the First Amended and Restated Declaration of Covenants, Conditions, and Restrictions for Grange (Residential Property), as same has been or may be amended and supplemented from time to time (the “Declaration”), upon acceptance of a deed to a Lot, each Owner acknowledged that the Lot is subject the requirements of the Declaration and other Dedicatory Instruments. No building, Hardscape, addition, modification (including tree removal), or improvement (a “Modification”) may be erected, placed, or performed on any Lot or Homesite until the construction plans and specifications, including the site plan, design development plan, and exterior plan, have been submitted to and approved in writing by the Grange Residential Association, Inc. Architectural Review Committee (“ARC”). Owners are required to complete and submit this Owner Modification Request Application (this “Application”) to the ARC together with plans and specifications for the proposed Modification. No Owner is entitled to commence work for a Modification unless the ARC has given written approval for it. To avoid delay in the ARC’s review and approval process, please complete this Application in full, print legibly or type your responses, and provide reasonable detail where descriptions are requested. Incomplete Applications will not be processed and will be returned to Owners. Incorrect information provided by an Owner for a proposed Modification, or changes made to a proposed Modification after approval has been granted, automatically invalidate and void the ARC approval for such Modification, and the Owner will be required to resubmit an Application for the proposed Modification reflecting correct information or the changes occurring to the proposed Modification in order to obtain ARC approval. Reference is made to the Declaration, to the Design Guidelines, and to the Modification and Maintenance Guidelines for all purposes. Unless otherwise set forth in this Application, the capitalized terms used in this Application are defined as set forth in the Declaration, in the Design Guidelines, and in the Modification and Maintenance Guidelines, and the interpretation provision set forth in the Declaration applies to this Application, which definitions and interpretation provision are incorporated in this Application for all purposes by this reference. The Declaration, the Design Guidelines, and the Modification and Maintenance Guidelines each contain requirements and restrictions for changes to Lots and improvements thereon. You are encouraged to review these Dedicatory Instruments to determine if your proposed Modification is permitted.

The failure of the ARC to approve this Application within 30 days after its receipt of the Application will be deemed to be a decision by the ARC denying the Application.

If the proposed Modification is approved, the undersigned Owner agrees to allow the ARC, its agents, or its employees to inspect the completed Modification, with reasonable notice, for purposes of verifying the accuracy of the information contained in this Application and compliance with the ARC’s written approval. Such inspection will be performed at a mutually agreeable time, between the undersigned Owner and the ARC, with such time to be no later than 30 days after completion of the Modification.
Proposed Modification Information:

In accordance with the Declaration, the Commencement of Construction must occur within 180 days from the date of plan approval, or other later date as determined by the ARC. Completion of Construction must occur no later than 2 years from Commencement of Construction, or other later date as determined by the ARC.
Proposed date for Commencement of Construction*

MonthDayYear
Date
Proposed date for Completion of Construction*

MonthDayYear
Date
Desribe the nature of the proposed Modification:*
Upload additional pages as neccesary:

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Location in or on the Dwelling and Lot where the proposed Modification will occur:*
Upload plan or drawing showing existing structures and any setbacks, building lines, and easements*

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Description, location, and dimensions of any structures for the proposed Modification:*
Dimensions (including height) of new improvements: *
Location of new improvements; distance from fences and easements:*
Finish Materials and Colors:*
List the Plans uploaded above for the proposed Modification:*
Where will materials be stored during construction?*
Other matters the ARC should be aware of regarding the proposed Modification:*
Please upload additional sheets if needed:

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This Application is intended as a tool to assist Owners and the ARC with the review process for proposed Modifications. Nothing in this Application is intended to amend, modify, alter, or change any requirements in the Dedicatory Instruments. In the event there is a conflict in this Application with any provision of a Dedicatory Instrument, the provision in the Dedicatory Instrument controls.
Owner Modification Request Form - Checklist

The checklist below is designed to assist the ARC in the review process for the proposed Modification. The Application must include a completed checklist in order for the review process for the proposed Modification to commence. If the completed Application and Checklist, together with the Plans, are not all included in the initial submittal package, the Application will be rejected and returned to Owner.
Please check each box that applies to your proposed Modification and Application.
For room additions or attached patio covers, professional drawings showing the existing Dwelling and the proposed addition or patio cover, including elevation and construction drawings with all dimensionsof the proposed addition or patio cover and detailing the roof pitch of the proposed addition or patio cover.*

YesNoN/A
Plans for proposed alterations to other structural improvements on a Lot, excluding the Dwelling, including, without limitation, design and all dimensions and measurements.*

YesNoN/A
Plans showing grading changes to the Lot and/or any impacts of the proposed Modification to drainage facilities.*

YesNoN/A
Plans showing changes to exterior elevations.*

YesNoN/A
For major landscaping changes, a list of the proposed type and location of proposed landscape material, including detail on landscaping borders and retaining walls, as applicable.*

YesNoN/A
Specifications for the proposed Modification including, without limitation, materials, equipment, colors, textures, and design characteristics. The ARC may request samples of proposed materials.*

YesNoN/A
Plans for exterior lighting, including, without limitation, style, size, quantity, material, and light specification.*

YesNoN/A
Any necessary permits from Waller County, and Waller County MUD 55, 55A, and 55B (Upload copies of permits and approvals.)*

YesNoN/A
A site plan of the Lot, showing the exact location and dimensions of the proposed Modification drawnon the site plan with the distance from Lot lines of the Lot clearly depicted.*

YesNoN/A
Color, quality photos of the area proposed for the Modification, along with a wide shot of the Lot,showing (i) the full area within the fence of the backyard or the full front yard area, and (ii) the locationof the proposed Modification on the photo, if possible.*

YesNoN/A
A copy or photo of the proposed Modification, which may include, by way of illustration and not limitation, brochures, manufacturer “cut sheets”, or catalog photos.*

YesNoN/A
I have read any provisions of the Declaration, the Design Guidelines, the Modification and Maintenance Guidelines, and any policies which apply to the Modification.*

YesNoN/A
The Modification, once completed, will be visible from a Common Area, sidewalk, or street adjacent to (or in close proximity to) the subject Lot.*

YesNoN/A
If neccesary, upload copies of permits and approvals from Waller County, and Waller County MUD 55, 55A, and 55B

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Deposit and Payment Information

Please select your payment type below and complete the required fields for that option. Each application submission includes a non-refundable $25 application fee. If you are applying for a pool, an additional $1,000 refundable deposit is required.
Form of Payment:*

CheckCredit Card PaymentElectronic Payment
Check Payment
Check #:
Name on Check:
Address on Check:
Electronic Payment
Form of E-Payment:
Transaction No.:
Credit Card Payment

Signature
I certify that the information contained in this Application, including supporting documentation, is an accurate representation of the proposed Modification. I also certify that the Modification, if approved, will be completed in accordance with the approved Application. I understand that work is not to begin until written approval has been received from the ARC.

DECLARANT, THE ASSOCIATION, THE ARC, THE BOARD, AND THE RESPECTIVE OFFICERS, AGENTS, MANAGERS, PARTNERS, DIRECTORS, SUCCESSORS, OR ASSIGNS OF THE FOREGOING, ARE NOT LIABLE IN DAMAGES OR OTHERWISE TO ANYONE WHO SUBMITS MATTERS FOR APPROVAL TO ANY OF THE AFOREMENTIONED PARTIES, OR TO THE OWNER(S) SUBMITTING THIS APPLICATION BY REASON OF MISTAKE OF JUDGMENT, NEGLIGENCE, OR NONFEASANCE ARISING OUT OF OR IN CONNECTION WITH THE APPROVAL, DISAPPROVAL, OR FAILURE TO APPROVE OR DISAPPROVE OF ANY MATTERS REQUIRING APPROVAL. APPROVAL BY THE ARC, THE BOARD, THE ASSOCIATION, OR ANY OF THEIR RESPECTIVE OFFICERS, DIRECTORS, AGENTS, MANAGERS, SUCCESSORS, OR ASSIGNS, IS NOT INTENDED AS ANY KIND OF REPRESENTATION, WARRANTY, OR GUARANTEE AS TO COMPLIANCE WITH LOCAL OR STATE LAWS AS TO THE INTEGRITY OR WORKABILITY OF THE PLANS OR AS TO THE CONTRACTORS USED.

OWNER(S) AGREE TO HOLD HARMLESS DECLARANT, THE ASSOCIATION, AND THE ASSOCIATION’S MANAGEMENT COMPANY, INCLUDING THEIR RESPECTIVE COMMITTEES, OFFICERS, AGENTS, MANAGERS, PARTNERS, DIRECTORS, AFFILIATES, SUCCESSORS, AND ASSIGNS (“RELEASED PARTIES”), AND RELEASE THEM FROM ANY LIABILITY IN CONNECTION WITH (i) THE APPROVAL, DISAPPROVAL, OR FAILURE TO APPROVE OR DISAPPROVE ANY MATTERS REQUIRING APPROVAL PER THE DEDICATORY INSTRUMENTS FOR THE PROPERTY, AND (ii) THE EXISTENCE, PLACEMENT, CONSTRUCTION, DESIGN, OPERATION, REPLACEMENT, AND MAINTENANCE RELATED TO THE PROPERTY (“RELEASED MATTERS”), AND AGREE TO INDEMNIFY SUCH RELEASED PARTIES FROM ANY LIABILITY RELATED TO THE RELEASED MATTERS.
Owner/Applicant*

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Date*

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Date
Owner/Applicant

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Grange Residential Association, Inc. Architectural Review Committee Owner Modification Request Application

Proposed Modification Information:

Owner Modification Request Form - Checklist

Deposit and Payment Information

Check Payment

Electronic Payment

Credit Card Payment

Credit Card

Signature