Architectural Review Form

First Name *

Last Name

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone *

Date *

Email Address *

I am requesting a variance for the following *Building AlterationLandscape ChangeOther

If Other Explain:

Nature of Alteration of Change: *

Materials to be used:

Contractor Name (if applicable)

Permit Approval Status (if applicable)

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