Lorton Valley Homeowners Association

Application for Exterior Modification

Version 2021

Proposed Improvement (1 project per application)

Signatures of Affected Neighbors

(those adjacent to your lot on all sides) are required for notification purposes only, however without signatures the application may be delayed for review:

I hereby certify that the information I have provided is accurate to the best of my knowledge. I further certify that, once approved, I shall construct the proposed improvement according to the approved plans, schedule, and specifications. Permission is hereby granted to members of the Lorton Valley Homeowners Association Covenants Committee, and its representatives, to enter on my property as necessary to review the proposed project.

Owners’ Acknowledgments (Please initial each box):

1. _____ That approval by the Architectural and Covenants Control Committee shall in no way be construed as to pass judgment on the correctness of the location, structural design, suitability of water flow or drainage, location of utilities, or other qualities of the proposed change being reviewed.
2. _____ approval by the Architectural and Covenants Control Committee shall in no way be construed as to pass judgment on whether the proposed change being reviewed is in compliance with the applicable building and zoning codes of the county in which the property is located. Likewise, local or state approval does not constitute ACCC approval. 
3. _____ That approval of any particular plans and specifications or design shall not be construed as a waiver of the right of the Architectural and Covenants Control Committee to disapprove such plans and specifications, or any elements or features thereof, in the event such plans are subsequently submitted for use in any other instance.
4. _____ That no work on the proposed change shall begin until written approval of the Architectural and Covenants Control Committee has been received by me; that, if work is begun prior to approval, I may be required to return the property to its former condition at my own expense if this application is disapproved wholly or in part; and I may be required to pay all legal expenses incurred.
5. _____ That there shall be no deviations from the plans, specifications, and location approved by the Architectural and Covenants Control Committee without prior written consent of the Architectural Control Committee; any variation from the original application must be resubmitted for approval.
6. _____ That I authorize members of the Architectural and Covenants Control Committee or managing agent to enter upon my Property to make one or more routine inspection(s). 
7. _____

   that construction or alterations in accordance with the approved plans and specifications must commence within 6 months of the approved date of this application and be completed within 12 months of the approved date, otherwise the approval by the Architectural ReviewCommittee shall be deemed conclusively to have lapsed and to have been withdrawn.

8. _____ That it is my responsibility and obligation to obtain all required building permits and to construct the improvements in a workmanlike manner in conformance with all applicable building and zoning codes.
9. _____ That I am responsible for any damage and all costs to repair green space or community property that result from the proposed modification.

Owner/Applicant Signature

_______________________________________      Date: __________

Co-Owner/Applicant Signature

_______________________________________      Date: __________

Required Attachments

Descriptive information (typically plans and specifications, including sketches, photos, catalog illustrations, etc. showing the nature, kind, shape, color, dimensions, materials, and a copy of the survey with the location marked). Please list Attachments:

Owner Signature: ______________________________________

Date: _________________________

Mailing Address (if different from Property Address):
____________________________________________________

Please Return To:

Covenants Committee
Lorton Valley Homeowners Association
c/o FirstService Residential, Inc.
11351 Random Hills Rd., Suite 500
Fairfax, VA 22030
Email: arc@fsresidential.com

Office Use Only

LORTON VALLEY HOMEOWNERS ASSOCIATION, INC.
RESPONSE TO DESIGN REVIEW APPLICATION

Date Action Taken: _______________________________________

Application Approved: Y     N

Application Disapproved: Y     N
(See comments below)

Delay of Action (Additional Information Requested)

Date Reconsidered: _______________________________________

Application Approved: Y     N

Application Disapproved: Y     N
(See comments below)

Stipulations and Conditions

1. All exterior modifications must meet the requirements of the Fairfax County Zoning/Building codes.
2. All exterior modifications must meet Fairfax County minimum setback specifications and may not be constructed across Building Restriction Lines (BRL) shown on individual site plans (plats).
3. All exterior modifications must meet the requirements of the Lorton Valley Homeowners Association Design and Maintenance Standards.
4. The proposed improvement must be constructed according to the approved plans, schedule (commenced within 6 months and completed within 12 months of the approval), and specifications.

Comments:

Date: _____________________________________________

_____________________________________________
Printed Name of Covenant Committee Member

_____________________________________________
Signature of Covenant Committee Member