PM Surveying Order Form

Red Fields Are Required

PM Surveying
Providing Land Surveying Services to South Florida

Date Ordered:
Date Needed:
Date Closing:

Please indicate purpose of survey:

Purchase/Refinance	Fence Installation
Pool Installation	Construction/Permit/Other
flood Insurance	Locate Well & Septic

If property is located within a flood hazard zone check here to include an elevation certificate.

Client (Invoice) Information:
Company
Attention:
Address:	Address2:
City:	State:	Zip:
Telephone:	Facsimile:
E-Mail:

Property data:
Address:
City:		State:	Zip:
Lot:		Block:
Subdivision:
Plat Book:	Page(s): Metes & Bounds (We will contact you for legal)

CERTIFICATION INFORMATION:

Financing:

--Refinance

--VA

--FHA

--Conventional

Borrower(s):
(To Appear on Certifications)
Home Phone:		Work Phone:
Seller:

Lender:
Title Co:
Title Underwriter:

PROPERTY ACCESS: (Please Check if Applicable)

Locked Fences
Gated Community
Dogs

DELIVER TO: (Please check one)
Title Company
Lender
Other
SPECIAL INSTRUCTIONS:

If the cost for the requested services is beyond or "normal" rates,
we will contact you for approval prior to the commencement of any work.

Please submit order below.

PM Surveying
4546 Cambridge Street
West Palm Beach, Florida, 33415
Office:(561)478-7764 Fax:(561)478-1094

Mark

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