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Name:
Mailing Address:
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Phone:
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Email:
Proposed Building Site Location for New Home
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County:
State:

Have you talked to a Builder or Rep?
Name:
Do you own land?
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Do you need assistance obtaining land?
Yes      No
Do you need assistance obtaining financing?
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Style of house interested in:
Ranch      2-Story      Loft      Multi-Family

Desired time frame to move into a new home?
Budget for house, excluding land:
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