APPLICATION FOR PERMIT

NEW MANUFACTURED HOME

It is requested that= a permit be issued for a new manufactured (mobile) home to be placed on Lot ______ Phase _______Address__________________________________________

on which all assessments and charges are current. I have received and read a copy of= the Indian Harbor Owners Association By= -Laws and Restrictions that apply to = my property. I will abide by the Restrictive Covenants, By-Laws = and the Rules and Regulations of the Association.

To expedite your approval and issuance of my permit, I submit the following as required:

= 1. Mobile model/make________________________ Year_________ Size __________

= 2. Approval from the Hood County Health Department for a new septic system.

Attach design specificatio= n on new systems or original design specifications on existing systems. _______

= 3. A recent survey or a verification of the original survey stakes. _____

= 4. Floor plan of the mobile home and a plat drawing showing placement of mobile home, porches, garage/carport on lot, showing required building lines and easement and set backs. _______

= 5. Include with drawing the steps and or porches including materials_______________ and Type of Underpinning ____________________________.

= 6. Carport______ Double______ Single______

Garage______ Double_______= Single_______

= 7. Driveway: MUST BE ASPHALT OR CON= CRETE. Surface type ___________________.<= /p>

= 8. A drainage culvert will____will not____ be required. Size required is ___________. Must be checked by the Road Committee. (Black corrugated culvert and/or PVC pipe are NOT permitted.)

= 9. Transporter/Installer___________________________________= _____________

Telephone # of Transporter= /Installer___________________

Proof of liability insuran= ce attached.________

= 10. If th= is dwelling replaces another mobile on this lot, I agree that the old mobile shall be removed from Indian Harbor within 15 da= ys after replacement mobile is installed.&nbs= p; I understand that after 15 = days a penalty of $10.00 per day will be assessed against me until the removal of = the old mobile is accomplished.

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= 11. Submi= tted with this request is the required fee of $1,000.00. I understand that if this mobile i= s not skirted within 30 days, as required by the Restrictions, a penalty of $5.00 per day will be assessed until such skirting h= as been accomplished.

= 12. If th= is permit is disapproved for any reason, the permit fee will be returned.

= 13. PERMIT MUST BE POSTED AT THE FRONT OF= THE LOT clearly visible from the street, during set up and clean-up. A $25.00 penalty will be assessed to me if the Permit is not posted _____ (Initial).

&nbs= p; _______________________= ____________________________________

&nbs= p; Print the Name of the Property Owner

&nbs= p; _______________________= ____________________________________

&nbs= p; Signature of the Property Owner <= span style=3D'mso-spacerun:yes'> = Date = Telephone

&nbs= p; _______________________= ____________________________________

&nbs= p; Current mailing address if different from the property

Approved_______ Disapproved ________ D= ate ____________

Reason(s) if disapproved:

&nbs= p; _______________________= ____________________________________

_______________________ ________ ________________________ ________

Architectural Control = Committee = Date = Architectural Control Committee = Date

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