1st Reading - Restated A&A Rules

Exhibit P – Satellite Dish Siting Form

Date of Request: ____________________________ Lot Number: ________________________________________

Name of Owner(s): ______________________________________________________________________________

Telephone 1: _______________________ Telephone 2: _____________________

Description of Satellite Dish/Antenna: _____________________________________________________________________________________________ _____________________________________________________________________________________________ Preferred Location of Satellite Dish: Attach sketch or map to this Exhibit P Form to assist the A&A Committee in siting the dish in the least obtrusive surrounding areas.

Date/Time Available for Satellite Dish Siting: _________________________________________________________

Additional Aesthetic Considerations by the A&A Committee: _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________

I, owner of lot _________ understand and agree:

1. I have read the A&A Rules and, if applicable, have furnished copies to the contractor engaged by me for this installation. 2. I agree to comply with the A&A Rules. If applicable, I also understand that it is my responsibility to ensure that my contractor also complies with the A&A Rules. 3. I agree that it is my responsibility to secure proper building permit if required by the local governmental entity.

Signature: __________________________

_____________________________

Owner 1

Owner 2

(For A&A Committee/Administration Use Below Only)

1. Date of Request Received: ____________________ Date of Siting: _________________ 2. A&A Committee and Owner have sited this satellite dish installation and approved its location as describe: _______________________________________________________

A&A Committee Member Signature

3. Additional Comments and Requirements: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Date: _________________________________ Approved By: ___________________________________________

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