Surveying Services Online Order Form
Company Name:
Select One
Century 21 Right Angle Realtors
Crossman Communities/Deluxe Homes
Homes by Prairie
Gunstra Builders
Other Company
Advantage Title, Inc.
Cathy Russell Team Real Estate
Francis Real Estate
Homes by Prairie
Lafayette Bank & Trust Co.
Lafayette Savings Bank
Member’s Title
Merit Realty, Inc.
Re/Max
Salin Bank & Trust
Shook Agency Colldwell Banker
Stallard & Schuh
Title First Agency
Other Company
Other:
Ordered by:
Name:
Email:
Phone:
Please check here if your request is a status update of an existing order.
Service Desired:
Boundary Survey - Rule 12 Survey
Land Title Survey- ALTA/ACSM Survey
Topographic Site Survey
Control Survey
Floodplain Determination & Certification
Survey Information:
Subdivision:
Select One
Buckingham Estates
Carrington Estates
Deerfield Farms
Hawks Nest
Hickory Meadows
The Landings
Lexington Farms
Raineybrook
Saddlebrook
Seasons Four
Shawnee Ridge
Sterling Heights
Stonehenge
Wake Robin
Other Subdivision
Other:
Section:
Phase:
Part:
Lot Number:
Brief Legal:
***If available please fax copy of legal description to 765-742-5271***
Street Address:
City/Town:
When Ready:
Call
Fax
Deliver
(downtown Lafayette)
Mail (enter mailing address here)
Special Instructions or Requirements:
