PROJECT # (assigned by City): ___________________
DECLARATION IN SUPPORT OF APPLICATION FOR CITY OF HOUSTON
(For Use by Individual Owners)
STATE OF TEXAS §
COUNTY OF HARRIS §
“My name is ____________________________________ and my address is _____________________
(First, Middle, Last)
__________________________________. I am over the age of eighteen and I am legally competent to make
this Declaration. I have personal knowledge of every fact stated herein and every fact stated herein is true and
correct. This Declaration will be submitted to the City of Houston, Texas (the ‘City’) as part of my Application
for a Building Permit for a project (‘the Project’) located or to be located in the ________________________
Subdivision, Block No. _____, Lot No. _________ (the ‘Land’). The physical mailing address of the Land is
______________________________________________, ______________________ Texas ______________.
I am an OWNER of the Land. I UNDERSTAND, for the purposes of my Application, the term ‘Deed
Restriction’ means any and every restriction or covenant contained in (or incorporated by reference into) a plan,
plat, replat, deed, or any other publicly recorded document that limits or affects the use of the Land in any way.
I UNDERSTAND copies of the Deed Restrictions, if any, are available for review at the office of the Clerk of
the County in which the Land is located. The Project does not violate the Deed Restrictions, if any, that
apply to the Land.
I UNDERSTAND AND AGREE that, if any fact stated in this Declaration is false, the City may void
any permit(s) issued by the City for the Project, and the City may order me and any other Owner to remove all
or part of the Project at my or our own expense.
I declare under penalty of perjury that the foregoing is true and correct.
Executed in ____________ County, State of Texas, on the ____ day of ___________________, 20____