PO Box 636 * Bastrop, TX 78602


To be completed by Property Owner

Property Owner’s Name: ___________________________________________________________

Owner’s Address: _________________________________________________________________

Home Phone: _______________ *Work Phone: ________________ Mobile Phone: ______________

Email Address: ____________________________________________________________________

Builder/Contractor Name: ___________________________________________________________

Builder’s Address: _________________________________________________________________

Email:______________________ Phone: _______________ Cell Phone: _____________________

Construction Site:

Property Legal Description: Unit: _____________ Block: ____________ Lot(s): ________________

Property Physical Address: ___________________________________________________________

Request for Building Approval {  } Check all that apply

{  } Residence Sq Ft _______ {  } Guest House Sq. Ft _____ {  } Outbuilding {  } Pool {  } Fence {  }

Garage/Carport {  } For How Many Vehicles?  __________

Other {  } Description:______________________________________________________________

Foundation:  {  } Slab {  } Pier and Beam

Comments: ______________________________________________________________________

Expiration of Permit:  

New Homes:  9 Months from date of issuance
Clearing: 3 Months from date of issuance
All other construction: 6 Months from date of issuance

Property Owners are responsible for all activities on their properties including the following:
•        Ensure that the permit is posted and visible from the road BEFORE construction starts
•        Have a Porta-Can brought to your property before construction begins
•        Have a roll-off trash receptacle brought to your property before construction begins
•        Ensure that construction site is kept clean and free of trash
•        Construction is completed by expiration of permit
•        Compliance with all building guidelines and the Covenants, Codes and Restrictions for
Tahitian Village Property Owners Association

By my signature below, I acknowledge that:
1.        Approval of this application is issued based on plans and specifications herein.  In the event
of substantial changes, I am required to submit a revised site plan for additional review.
2.        Any required variances must be obtained prior to beginning the work that involves the
3.        The planned septic tank system or other sewage disposal system meets all applicable laws,
rules, standards and specifications.
4.        I am bound to all rules and regulations relating to development in Tahitian Village
subdivision including:
a.        The CCRs and By-Laws of Tahitian Village Subdivision
b.        Bastrop County Development requirements
c.        State of Texas Requirements for Development or Remodeling in Unincorporated areas
d.        When applicable, City Of Bastrop, Texas Development requirements
5.        It is my responsibility to ensure that all provision of this application are faithfully performed.

Property Owner(s)

_____________________________________        _________________________________
             Signature                                                Printed                                        Date

_____________________________________        _________________________________    
             Signature                                                Printed                                        Date

If you want your builder or agent to speak for you during construction, please indicate below.

I authorize ______________________________ of ______________________________________
to act on my behalf pertaining to all aspects of the construction of the aforementioned

_________     ________
Initials             Initials

For completion and use by TVACC

Date received by TVACC: ______________   Fee Attached:   $___________  Check No. _________

Application submitted is: Approved         Not Approved: ______________ Date: ________________

Conditions to Approval: ____________________________________________________________

_______________________        __________________________        _______________________
TVACC                        Date           TVACC                                                Date
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