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Neighborhood Review Submission Form

2. SECURITY CODE:*

3. ADDRESS:*

5. NUMBER OF BEDROOMS:*
   -- Select One --12345678

7. NUMBER OF BATHROOMS:

8. FULL*
   -- Select One --123456

   INCLUDES TOILET, SINK, SHOWER AND/OR TUB

9. HALF*
   -- Select One --1234560

   INCLUDES ONLY TOILET AND SINK

11. TYPE OF BASEMENT:*

    1. FULL

    1. CRAWL

    1. SLAB

    1. MIX

13. AREA OF FINISHED BASEMENT:

14. SQFT

15. % OF TOTAL BASEMENT

17. QUALITY OF BASEMENT FINISH:

    1. LIVING

    1. RECREATIONAL

    LIVING: COMPLIES WITH BUILDING STANDARDS IN THE SAME MANNER AS ROOMS ABOVE GRADE

19. NUMBER OF FIREPLACES:

20. GAS*
    -- Select One --0123

21. WOOD*
    -- Select One --0123

22. WOOD STOVE*
    -- Select One --0123

24. BUILT INS*

    1. DISHWASHER
    2. GARBAGE DISPOSAL

    1. MICROWAVE
    2. RANGE

    1. HOOD/FAN

    1. CENTRAL AIR CONDITIONING

26. GARAGE INTERIOR FINISH*

    1. YES

    1. NO

27. GARAGE AUTO DOORS:*
    -- Select One --01234

29. EXPLANATION OF ABOVE IF NEEDED:

31. INTERIOR IMPROVEMENTS AND/OR ANY ISSUES WITH THE PROPERTY:

33. PERMISSION TO MEASURE EXTERIOR OF HOME:*
    -- Select One --YESNOAPPOINTMENT

35. ELECTRONIC SIGNATURE AGREEMENT:*

    BY CHECKING THE "I AGREE" BOX BELOW, YOU AGREE AND ACKNOWLEDGE THAT 1) YOUR APPLICATION WILL NOT BE SIGNED IN THE SENSE OF A TRADITIONAL PAPER DOCUMENT, 2) BY SIGNING IN THIS ALTERNATE MANNER, YOU AUTHORIZE YOUR ELECTRONIC SIGNATURE TO BE VALID AND BINDING UPON YOU TO THE SAME FORCE AND EFFECT AS A HANDWRITTEN SIGNATURE, AND 3) YOU MAY STILL BE REQUIRED TO PROVIDE A TRADITIONAL SIGNATURE AT A LATER DATE.

    1. I AGREE
37. ELECTRONIC SIGNATURE:*

38. PHONE NUMBER:

    ONLY IF YOU WOULD LIKE TO SCHEDULE AN APPOINTMENT

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field