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Counties Serviced by Holland Office:
Allegan, Kent, *Montcalm, Muskegon, *Newaygo and Ottawa
*mortgage inspections are not offered to these counties

Counties Serviced by Southfield Office:
Oakland, Genesee, Lapeer, Macomb, Wayne, Washtenaw and Livingston and other surrounding counties on a project-by-project basis.
   
Client Information:
Ordered By (Company Name)

Certify To (If other than ordered by)

Attention (Your Name)
Client’s Last Name
Billing Address 1
Billing Address 2
City
State
Zip Code
Email
Phone
Cell/Alternate Phone

Fax:

 
Property Information:
 

Property Address 1

Property Address 2
City
State
Zip Code
  
Date Needed By
Date Ordered
  
HEI Job Number
Parcel Number
   
Legal Description (Title Work must be received prior to the start of any work. Please email Title Work to surveyholland@hollandengineering.com):
   

Services Requested:

Mortgage Inspection (No corners verified or marked / No stakes)
Boundary Survey (With 4-foot wood stakes marked with pink ribbon and irons in corners only)

Boundary Survey with Improvements (Buildings, fences, etc., shown / With 4-foot wood stakes marked with pink ribbon and irons in corners only)

Commercial Property Mortgage Inspection (No corners verified or marked / No stakes)

Commercial Property Boundary Survey (With 4-foot wood stakes marked with pink ribbon and irons in corners only)

Commercial Property Boundary Survey with Improvements (Buildings, fences, etc., shown / With 4-foot wood stakes marked with pink ribbon and irons in corners only)

FEMA Elevation Certificate (Flood)

   

Special Instructions or Additional Work:

   
(For any questions/information not on this form, please contact our Holland office at (616) 392-5938).
   

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