Form Center

Neighborhood Review Submission Form

2. SECURITY CODE:*

3. ADDRESS:*

5. OCCUPANCY:*

   1. SINGLE FAMILY
   2. TWO-FAMILY

   1. DUPLEX

   1. FOUR-PLEX

   1. GARAGE ONLY

   TWO-FAMILY - SUBMIT ALL ON ONE FORM. DUPLEX/FOUR-PLEX - IF UNITS ARE IDENTICAL, SUBMIT ONE FORM AND INDICATE SUCH AT BOTTOM, IF UNITS ARE NOT IDENTICAL, SUBMIT FORM FOR EACH UNIT AND INDICATE SUCH AT BOTTOM (YOU MAY USE THE SAME SECURITY CODE FOR EACH)

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

9. NUMBER OF BATHROOMS:

10. FULL*
    -- Select One --123456

    INCLUDES TOILET, SINK, SHOWER AND/OR TUB

11. HALF*
    -- Select One --1234560

    INCLUDES ONLY TOILET AND SINK

13. TYPE OF BASEMENT:*

    1. FULL

    1. CRAWL

    1. SLAB

    1. MIX

15. AREA OF FINISHED BASEMENT:

16. SQFT

17. % OF TOTAL BASEMENT

19. QUALITY OF BASEMENT FINISH:

    1. LIVING

    1. RECREATIONAL

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

21. NUMBER OF FIREPLACES:

22. GAS*
    -- Select One --0123

23. WOOD*
    -- Select One --0123

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

26. BUILT INS*

    1. DISHWASHER
    2. GARBAGE DISPOSAL

    1. MICROWAVE
    2. RANGE

    1. SEPARATE OVEN & COOK TOP
    2. HOOD/FAN

    1. CENTRAL AIR CONDITIONING
    2. NONE

    NOTE: EVERY HOME SHOULD HAVE EITHER A RANGE OR SEPARATE OVEN AND COOK TOP UNITS

28. GARAGE INTERIOR FINISH*

    1. YES
    2. NO

    1. NO GARAGE

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

31. EXPLANATION OF ABOVE IF NEEDED:

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

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:*

Leave This Blank:


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

    This field is not part of the form submission.

41. Submit

* indicates a required field