HOME IMPROVEMENT REQUEST FORM
Name:
*
Project #:
Address:
*
Home Phone
*
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
1. Will this home improvement/addition involve structural changes in the original construction of this home?
*
YES
NO
2. Reason for request for improvement/addition: (Check one)
*
A. Energy Conservation
B. Improvement of looks or value of home
C. Increase in home size
D. Renovation of existing house
Other
3. Describe extent of home improvement or addition:
*
4. Estimated cost of improvement/addition:
*
$ amount
5. Description of materials needed for improvement/addition:
*
6. Name of proposed builder or contractor:
*
Address:
*
Phone:
*
Format: (000) 000-0000.
7. Attach schematic drawing of improvement/addition in relation to existing house.
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I understand that any improvements or additions to my home becomes part of the existing structure and if I should move from my home, all improvements or additions will remain with the house, and the Absentee Shawnee Housing Authority shall not be obligated to compensate me for these improvements/additions.
Homebuyer Signature
*
Date
*
-
Month
-
Day
Year
Date
Spouse Signature
Date
-
Month
-
Day
Year
Date
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