THIS FORM IS TO BE COMPLETED BY THE HOMEOWNER AND SUBMITTED FOR APPROVAL PRIOR TO THE COMMENCEMENT OF ANY WORK. PLEASE SUBMIT TO SEMINOLE LAKES POA, C/O STAR HOSPITALITY MANAGEMENT, 26530 MALLARD WAY, PUNTA GORDA, FL, 33950, PHONE: 941-575-6764, FAX: 941-575-7968, E-MAIL: star@sunletter.com.

Date of Request: ______________

Property Address: ____________________________________________________________________________________

Property Owner’s Name: ________________________________________ PHONE: _______________________________

Mailing Address (If different than property address):__________________________________________________________

Type of Work to be Approved (Check all that apply):

______ Exterior Color Selections for Painting (attach color samples; denote body and trim colors)

______ Construction Project such as lanai or addition (detail style, size, and plat plan to be included)

______ Roof (detail type, color, and composition of material)

______ Windows and/or Hurricane Shutters (detail type, color, and composition of material)

______ Pool (detail color of any screen enclosure and detail how pool equipment will be screened from view)

______ Landscaping

______ Other

Provide Complete Description of Improvements (Attach additional pages if necessary):

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

Contractor: ____________________________________Lic.#.______________ Phone: ____________________________

Architect: _________________________________________________________ Phone: ___________________________

Anticipated Start Date: __________________________ Anticipated Completion Date: _____________________________

Prerequisites: As a prerequisite to consideration for approval, and prior to beginning the addition, alteration, or improvement, a complete set of plans and specifications must be submitted. Upon getting written approval, construction may begin and progress to completion promptly, and in strict conformity with such approved plans and specifications. Board shall be entitled to stop any construction in violation of these restrictions and any such exterior alteration made without having first been approved as provided above shall be deemed to be in violation of the Covenants and may be required to be restored to the original condition at the Owner’s expense.

Permitting: Requests and alterations must conform to all local Zoning and Building Regulations. You are required to obtain the necessary permits if your request is approved and submit a copy of said permit (s) to Star.

Liability: Property Owner must accept liability for damage to common areas, adjacent Owner’s property, or to any easements and must promptly remedy damage thereto caused in part or in whole by contractor’s operations at no cost to the POA or other Owner.

Signature: By my signature below, I certify that all information provided within this application for review is true and correct. I also understand that regular maintenance of any requested alteration, addition, or improvements is my responsibility in accordance with our governing documents and any amendments thereto or duly adopted rules of the Board of Directors. I understand that removal of a modification may be requested by the Board at my expense, should the modification not meet the specifications.

___________________________________________

Homeowner Signature

POA Board Determination:

( ) Prior Approval Date: ___________ Signature __________________________________________

( ) Final Approval Date: ___________ Signature __________________________________________

( ) Not Approved Date: ____________ Signature __________________________________________

Comments/Conditions: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________