Architectural Modification Form		Please submit to:

Request for Structural/Landscaping	Evergreen Estates Homeowners Assn.
Addition or Modification		Architectural Control Committee
					c/o Zalco Realty, Inc.
					8701 Georgia Avenue
					Silver Spring, MD 20910-3713


Name________________________________	Date___________Acct #____________


Street Address______________________	Telephone (H)____________________


____________________________________		  (W)____________________


DESCRIPTION/DIAGRAM OF MODIFICATION REQUESTED: Please include a description
and diagram (sketch or picture, if appropriate) of addition or modification.
If more space is needed, please attach a separate sheet.


_________________________________________________________________________


_________________________________________________________________________


_________________________________________________________________________


_________________________________________________________________________


I [We] acknowledge and agree that I [We] will be soley liable for any
claims, including and without limitation, for property damage or personal
injury, which result from the requested addition or modification.  I [We]
hereby indemnify the Homeowners Association from, and against, any and all
such claims.  I [We] understand and acknowledge that I [We] am [are]
responsible for complying with all applicable building codes and ordinances,
and for obtaining all necessary permits and inspections for the requested
addition or modification and further, that I [We] am [are] responsible for 
all maintenance, repair and upkeep of said addition or modification.


____________________________________	_________________________________

(Signature of Owner)                    (Signature of Co-Owner)	

Return to Architectural Control Page

Return to Evergreen Estates Home Page

This page is hosted by Get your own Free Homepage