SIX MILE CREEK HOA
ARCHITECTURAL REVIEW COMMITTEE (ARC)
REQUEST FORM
ALLOW THIRTY (30) DAYS TO PROCESS YOUR REQUEST
Project Start Date: ______________________ Project Completion Date: __________________________
Two (2) ARC Request Forms and two (2) sets of plat maps (where applicable) are required with each request. If you are
requesting more than one (1) project approval that requires an ARC request to be done at the same time, submit the
request forms for each project. {i.e. a screen enclosure and installing a fence requires two (2) complete ARC request}.
HOMEOWNER: _________________________________________ PHONE: ________________________________
Name (Please Print)
Address : ____________________________________________________________________________________
Location where work will be done (please print)
Homeowner’s Signature: _____________________________________________ Date: ____________________
Purpose of Request: Check appropriate items.
______Exterior painting of home. (Attach color chip samples, denote body, trim, & roof color. Once colors are approved,
you May Not change those colors in any way without submitting another ARC request.
______ Fence Installation __________ Enclosing A/C, Pool Equipment, Water Softeners, etc. ________ Pool
_________Screen Enclosure _________ Re-Roofing ______ Other ____________________________________
Attach two (2) copies of your plat map with the proposed fence, pool, or screen enclosure location sketched onto each
one, denote type, height, color & gate locations, etc. (If applicable). NOTE if location of property to be fenced boarders
the Sound Wall barrier plans must include 8 ft easement gating at both section which butt up to the Sound Wall Barrier.
No fencing, gating or posting can be attached to the Sound Wall Barrier in anyway. 48 hour minimum notification will be
given prior to entrée.
This ARC request has been reviewed for the limited purpose of determining if it complies with the deed restrictions set
forth in the Six Mile Creek Covenants and By-laws. No ARC review has been made with respect to function, safety, or
compliance with government regulations. Brevard County building permits where applicable must be obtained before
the approved project begins. The undersigned expressly disclaim liability of any kind with respect to this request, the
review hereof, or any structure built pursuant hereto, including but not limited to, liability for negligence or breach of
contract, or implied warranty. An approved ARC request is valid for the period of “Project Start Date” through”Project
Completion Date” only. Project approval is valid only if applicant is legally documented as the true owner of property
listed as location of project.
ARC ACTION: Date Received __________________ (_________) Approved (__________) Not Approved
Remarks:__________________________________________________________________________________________
Mike Runnells __________________________________________ Date: _____________________
Joe Carlon _____________________________________________ Date: _____________________
Don Reese _____________________________________________ Date: _____________________
PLEASE SUBMIT TWO (2) COMPLETED ARC REQUEST FORMS
Return completed forms to:
Mike Runnells
1215 Ambra Drive, Melbourne, FL 32940
(321) 224-4862