DEERFIELD HOME OWNERS ASSOCIATION

ARCHITECTURAL CONTROL COMMITTEE APPROVAL FORM

Please complete this form and submit via one of the following options:

Fax to: 425-896-0454.

Email to address: deerfieldHOA@hotmail.com.

Mail to: 704 228^th Avenue NE #144

Sammamish, WA 98074

Property Owner Name:______________________

Property Address: ____________________________

Phone:________________________ Lot Description:_________________________________

Paint: Exterior only House Color: ___________________ Trim Color:_____________________

Home Addition: (requires schematic of project/architectural plans, etc._______________________________

Roof Replacement: (provide brochure of material and comply with "SHAKE LIKE" appearance in texture and thickness, no red, blue or green.)

Acceptable roofing material: Shake, Composition – Presidential TL or higher grade

Description of requested roofing material:________________________________________

Landscape: (should conform to neighborhood appearance and applicable covenants)

Description of landscape project ____________________________________________________________

Approval is Granted___________ Date:________________

Approval not Granted ___________ Date:_______________

Reason for non-approval:____________________________________________________________________

_________________________________________________________________________________________

Committee member signature, (only one required)

ACC Committee member: _______________________________ Date: ______________________________

Committee Members:

Kent T Kiernan, 425-898-9457 Doc O’Connor 425-8987382 Form:ACC 5/2007