Engineering Services Request

Contact/Client Name

First NameLast Name

*Business Name

*If Applicable

Phone Number

Format: (000) 000-0000.

Email

example@example.com

Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is the Project Address the Same as the Billing Address?

Project Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Service Needed

Residential or Commercial Site

New Construction or Replacement/Repair

Type of Water Service

Structures To Be Serviced by Septic System (OWTS)

*List all structures that will be connected to the system.

Total Number of Bedrooms

*Include all bedrooms in any structure that will be connected to the system.

Potential for Future Bedrooms

Number of Future Bedrooms

Description of Commercial Activity

Have you obtained a soils evaluation report for this site?

Would you like us to obtain a soils evaluation report for you for an additional fee?

Structure(s) to Be Evaluated

Structural Issue(s) to Be Evaluated

Please Note:

In order to complete your septic (onsite wastewater treatment) system design we also request that you provide the following information:

A soil evaluation report, unless we are obtaining that for you
A plot plan showing the property lines and all structures on the site: This includes existing, and proposed structures such as residences, detached garages, shops, pools, gazebos, etc.
Any other information or documents that may help us in completing this project

This information can be emailed to: drurypropertyservices@gmail.com

Engineering Service Request Form