Lorton Valley Homeowners Association

Application for Use of Portable Basketball Equipment

Applicant Location Request

I, , hereby request approval to place a portable basketball backboard in the following location:

Driveway of my single-family home at:

or

End of the cul-de-sac or turn-around on (Name of Street):

Acknowledgments (Please Initial)

• ____ I am aware of and can comply with the restrictions noted in the Design and Maintenance Standards document regarding minimum lot size and slope and general location of driveway as it relates to community streets and adjoining neighbors’ homes/driveways..
• ____ I am aware of and will comply with the restrictions on no painting/marking of driveways and/or streets.
• ____ I will comply with approved hours and times of play.
• ____ I will maintain the equipment in accordance with established guidelines.
• ____ I understand and will comply with established rule governing no night-time lighting.
• ____ I understand this approval may be rescinded for cause.
• ____ This approval is not transferrable to another person.
• ____ I understand that renewal of the application is required every three (3) years to accommodate interests of new homeowners.

Neighbor Endorsements

The undersigned neighbors have been informed and are not opposed to the use of basketball equipment at the above location, with the understanding that all HOA rules will be followed:

Applicant Signature

Applicant Signature: ___________________________________    Date: ________________

Co-Applicant Signature: _________________________________    Date: ________________