First Name:
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Last Name:
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Street Address 1:
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Street Address 2:
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City:
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State:
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Home Phone:
() -
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Email Address (Primary)
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Primary Contact:
Time To Contact:
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Do you currently rent or own?
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If you own a home, is your current house for sale now?
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Type of home desired?
slab
unfinished basement
finished basement
crawl space
unfinished basement / upper level garage / no bonus room
unfinished basement / upper level garage / bonus room
finished basement / upper level garage / no bonus room
finished basement / upper level garage / bonus
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If Single Family, what size?
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If Large Single Family, what size?
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Number of stories (not including basement)
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What Price Range Are You Most Interested In?
$151,000 - $200,000
$201,000 - $250,000
$251,000 - $300,000
$301,000 - $400,000
$401,000 or greater
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When do you want to build?
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What type of build do you want to do?
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In what area do you want to build?
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Do you already have a lot / property?
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If yes, where?
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If yes, is property on septic or sewer system?
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If on septic system, do you have a perc test &/or permit?
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How did you hear about us?
Radio / 101.1 FM The Source / The Attack Machine
Radio / 101.1 FM The Source / Matt Murphy
Radio / 93.7 FM WDJC
Radio / 690 AM JOX / Dunnaway & Brown
Radio / 100.5 FM JOX / The Opening Drive
Yellow Pages
Friend / Family
Mortgage Lender
Realtor
Trade Show
Internet Search
OTHER
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If other, please specify:
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| Select project(s) you are interested in: |
| Built By U Homes Client |
| Rusert Homes LLC |
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