9 APPENDIX D COMMUNICATIONS EQUIPMENT REGISTRATION FORM

9 APPENDIX D – COMMUNICATIONS EQUIPMENT REGISTRATION FORM 
This form is available on www.PCVA.org or on the PCVA Homeowner Portal at https://portal.ehammersmith.com/Home_v2/Login

Communications Equipment Registration Form
Owner’s Name:                                                                                                                        
Property Address:                                                                                                                    
Phone Number:                                                           
Email Address:                                    
Type of Equipment (Satellite Dish, Antenna, Internet Equipment, etc.)
Size:                                                                             Color:                                                  
(Please attach a flier showing the unit or provide a sketch on the reverse of this form.)

Please describe the proposed location for the placement of the equipment.



 
 
How will the unit be mounted? (i.e. bolted to the siding, attached to eave, mounted on a support post)



 
Have you reviewed Section 2.8 of the Community Guidelines for Communication/Satellite Equipment placement?         Yes       No

Does your proposal meet the intent of the Guidelines regarding minimal visual impact?
Please explain how the location of the equipment has minimal visual impact.



 
 
Owner’s Signature:                                                                Date:                                    



 
Hammersmith Management, Inc
1155 Kelly Johnson Blvd Suite 495
Colorado Springs, CO 80920
Fax: 719-328 0756