Request for Change to or Addition of Building

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Request for Change (including color) to or Addition of Building

This form is provided to facilitate your communicating your request for approval to the Board of Pioneer Ridge (Highpointe) Homeowner Association. Please complete the relevant portions of the form and deliver the form to a board member. Comments of owners of adjacent lots are not required, but are helpful. As the Board will be soliciting the comments of these owners, inclusion will facilitate the process and allows you to explain your own project.

Lot No.:________ Homeowner Name:____________________________________________

Mailing Address:__________________________________________________________

Phone No.: (____) ____-_________

Describe project (Please attach drawing, sketch, or color sample): ________________
____________________________________________________________________________
____________________________________________________________________________

Homeowner signature:_____________________________________ Date: _________________

Comments of owner of adjacent lots:

Lot no.: ______ Signature: __________________________________ Date: _______________
Comment: ____________________________________________________________________
____________________________________________________________________________

Lot no.: ______ Signature: __________________________________ Date: _______________
Comment: ____________________________________________________________________
____________________________________________________________________________

Lot no.: ______ Signature: __________________________________ Date: _______________
Comment: ____________________________________________________________________
____________________________________________________________________________

Lot no.: ______ Signature: __________________________________ Date: _______________
Comment: ____________________________________________________________________
____________________________________________________________________________

Board members are listed in the directory and may also be found on the web site http://www.covingtonshighpointe.com. The Association mailing address is

Pioneer Ridge (Highpointe) Homeowners Association
% Jacqueline M Perriella, CPA
11602 SE 163RD ST
Renton WA 98058-5360

Form maybe mailed to the Board at board@covingtonshighpointe.com