Real Estate Modification Variances

REAL ESTATE MODIFICATION VARIANCES

This Real Estate Modification Variances form documents a request by the Property Owner or Authorized Applicant to modify an existing approved plan, restriction, or improvement standard relating to the Property identified below, and to request one or more variances from applicable association, covenant, or approval conditions. Submission of this form constitutes a written application for review, and, if approved, will constitute an amendment to the original approval subject to the conditions set forth herein.

PARTIES

PROPERTY IDENTIFICATION

Property Address:

Parcel / APN Number:

REQUESTED MODIFICATION(S) AND VARIANCE DETAILS

Nature of Request (check all applicable):
Structural alteration Exterior finish / color change Landscaping / hardscape Fence / wall Other

Relief requested (cite rule, setback, measurement, or standard from which variance is sought):

SCHEDULE, CONTRACTOR & COSTS

Proposed Commencement Date: Estimated Completion Date:

DISCLOSURES & IMPACTS

Will the proposed modification result in any of the following? (select Yes or No)

Encroachment onto common area: Yes No

Alteration of drainage or stormwater flow: Yes No

Removal of protected trees / vegetation: Yes No

REPRESENTATIONS, CONDITIONS & INDEMNITY

Applicant represents and warrants that all information provided is true and correct, that Applicant is the owner or has authority to act on behalf of the owner, and that all work will be performed in compliance with applicable building codes, permits, and legal requirements. Applicant agrees to indemnify and hold harmless the Approving Authority, its directors, officers and agents from any loss, claim, damage or expense arising from the proposed modification or the grant of the variance, except to the extent caused by the Approving Authority's gross negligence or willful misconduct.

Any approval granted is conditional and may include reasonable restrictions, performance bonds, restoration obligations, or as-built documentation. Approval may be revoked if Applicant fails to comply with the conditions or if the work deviates materially from the approved plans.

REVIEW, DECISION AND CONDITIONS (FOR AUTHORITY USE)

Decision (check one): Approved Approved with Conditions Denied

This decision supersedes any prior inconsistent approvals only to the extent expressly stated. Applicant must obtain and maintain all required permits and provide evidence of permit issuance if requested by the Approving Authority.

DEFAULT, REMEDIES & GOVERNING LAW

Failure to commence or complete work in accordance with approved plans or conditions, or failure to correct violations after notice, shall be grounds for revocation of approval and may subject the Applicant to restoration obligations and assessment for costs. The Approving Authority's remedies are cumulative and may include injunctive relief, remediation, and recovery of costs. This Agreement shall be governed by the laws of the state in which the Property is located.

ENTIRE AGREEMENT

This form, together with any approved plans and written conditions, constitutes the entire agreement between the parties with respect to the requested modification and variance and supersedes any prior oral or written statements or approvals, unless expressly incorporated in writing.

APPLICANT CERTIFICATION

By signing below Applicant certifies under penalty of perjury that the information contained herein is true and correct, that Applicant is authorized to request the modification and any variance sought, and that Applicant will comply with any conditions imposed as part of an approval.

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