I (agent or builder) request the issuance of a building permit to construct the improvements described in the attached plans and specifications. By signing this letter I certify that I
have a copy of the DECLARATIONS OF COVENANTS, CONDITIONS, AND RESTRICTIONS (CCR’S) for the Hidden
Shores at Lake Cisco Property Owners Association and that I have read and familiarized myself with those
Documents. Further, I certify that the house and site design has been developed with the full knowledge of and
adherence to the CCR’s and that construction and Jobsite conduct will proceed accordingly. As an agent or builder, I authorize the designated personnel of the Hidden Shores at Lake Cisco Property Owners Association to inspect the above-described property and improvements. As agent or principal, I indemnify and hold
harmless the Property Owners Association and their designees against any and all claims or loss except that of willful misdeed or gross negligence. In the event that an item of construction does not satisfy the requirements of
the Hidden Shores at Lake Cisco Property Owners Association. CCR’s, repair, replacement and/or augmentation of that item will be performed until that item does satisfy the requirements of Hidden Shores at Lake Cisco, LLC.

Per each application of new home construction, a fee of two hundred and fifty dollars, $250.00 is required.

Please make check payable to Hidden Shores at Lake Cisco Property Owners Association . All maintenance and inspection fees will be paid before a Statement of Completion will be issued. Issuance of a Statement of
Completion does not release the builder from any of the liability normally associated with construction and does not limit in any way the implied or actual warranties or liabilities that the builder is normally obligated.

Plans Submitted: YesNo
Plot Plan Submitted: YesNo

Location:
Lot: Blk: Addition/tract:
Physical Address:

Contractor/Owner:
Owners name: Phone:
Owners Email:
Brokerage Company: Phone:
Brokerage Address: Description of Home
Style:

Number of Bedrooms: Number os Baths:
Total Finished Area: Unfinished Area (Sq.ft & Location)
Garage Area: Number of Garage Stalls:

Price Range/
Sale Price:
Construction Schedule
Proposed Construction Start Date:
Proposed Construction Completion Date:
COLOR SELECTION: Use this form for the exterior color selection approval process.
Please attach a color swatch and deliver it to our office.
Body: Trim: Door:
Paint Manufacture:
CERTIFICATION
I (we) certify that the above information provided constitutes a description of the proposed building, items of construction, location, and the site will be in accordance with the Hidden Shores at Lake Cisco Property Owners’ Association DECLARATION OF COVENANTS, CONDITIONS, AND RESTRICTIONS set forth in Hidden Shores at Lake Cisco Subdivision.
I (we) further certify that the work will be completed in a timely, workmanlike manner and that the building site and adjacent areas will be free of litter and debris during construction.
Owner:
Builder:
Date:
Hidden Shores at Lake Cisco Architectural Review Board Signatures:
Date:
Date:
Date:
Approved/Approved as noted: Date:
Notes:
Rejected as noted: Date:


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