BLD2022-1627_Letter_11.28.2022_10.03.13_AM_3238788RICE MAR CC
(Required„ along with a F
homeowner project that afl
area or the strac
Unit # 2-01
Statement of Work (Manufa
INM% 'J1VI PROJECT REQUEST FORM
) HARMLESS agreement, for any
any common area, limited common
integrity of the building)
I Model Name 1 Model # of insert):
aMificatiQns-
Estimated start and completionlate:
e -0 2.OZZ.
Contractor's Company Name:
Contractor's Business License
Contractor's Insurance
Number:
Bond Documentation #
A 41
Policy
` 8136
A-tJD Q-'. s -
Homeowner
name(s): f, a,,;n :sur- Address: 5�z4 k4cp cr-
Ls
Phone: at Ig zags cc � 42sS b9� -3��� csc —) Email:
Signature:_z
Date: 11_a-2,2-
After the homeowner has completed the above sections and signed
and dated, the Project Request form, along with copies of the
contractor's business license(s), proof of insurance and bond
information, should be submitted to Georgianna Chamberlain,
the Property Manager, at Geargianna�pelandgrp•com•
f �
Approved by ot'4' AW4/4a4XT Date