Weldon L. Brown Company, Inc.
Satellite Dish Installation Request Form

Please fill out this form COMPLETELY and press the submit button.
Or you may complete and print out a copy of this form and fax to: (951) 682-5632. You will also need to fax us a sketch or map of the preferred location of the satellite dish to assist Association's designated representative in Installation the location of dish which would be least obtrusive to the surrounding area.



**Required Fields

**Date of Request:
**Lot/Tract #:
**Owner/Applicant:
**Address:
**Local Phone #:
Other Phone #:
Description of Satellite Dish/Antennae:
Suggested Date/Time Available for Installation:

BY SUBMITTING THIS FORM YOU UNDERSTAND AND AGREE AS FOLLOWS:

1.  I have read the architectural guidelines and, if applicable, have furnished copies to the contractor engaged by me for this installation.

2.  I agree to comply with the architectural guidelines. If applicable, I also understand that it is my responsibility to ensure that my contractor also complies with the architectural guidelines.

3.  I agree to be responsible for the care, maintenance, damage caused, repair and replacement of any satellite dish installation and shall be required to paint, repaint, if for any reason the exterior surface of the antennae becomes worn or deteriorated.

4.  I agree that it is my responsibility to secure proper building permits if required by the local governmental entity.




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