LOT #__________________

Waterford Landing Architectural Review Board

Submit two each of the following items:

-Building Plans

-Building Specifications

-Plat Plans showing set backs, building locations, driveways and easements

*NOTE:  Proposed Building Site to be Staked Prior to Excavation

I, ____________________ hereby verify that I have read, understood and agreed to the
        “Property Owner “

Declaration of Restrictions of Waterford Landing as recorded in the Clerk of Courts Office-Dinwiddie County Courthouse and that this information will be provided to the appropriate contractors to assure compliance.

Plans received on ____________________ Plans received by ___________________

Written approval by the ARB is required before any construction begins.  Property owner will be notified of a decision within 14 days of receipt of two complete packages.

Contact Numbers for Members of the ARB/Signature Approval and Date

Bo Clayton                                       ____________________________    ________

Ronnie Harris                                    ____________________________    ________

Stanley Parham                                   ____________________________    ________

Bryan Cobb                                      ____________________________    ________

Russ Beck                                         ____________________________    ________

Owner Name: ___________________________________Lot #_____ Section # _____

Address: _________________________________________________________

Phone:  Day______________ Evening______________ Cell_________________