E-mail to
movers@mtcnet.net
or Fax to (712) 439-2523
Date:
/ /
Name: ________________________________
Home Phone: ( )
-
Street: ________________________________
Work Phone: ( )
-
Cell Phone: (
) -
City & State: ___________________________
Zip Code: ____________________
Fax: (
) -
Move From (Present Location): _____________
Within City Limits _______ Outside City Limits _______
Move To (Future Location):_________________
Within City Limits _______ Outside City Limits _______
Distance/Miles_______ Size:_______
Height: _______Stories:_______ Eve/Overhang Width _______
Structure/Type:
House _______ Double Wide _______ Barn _______Pole Shed _______
Garage _______Steel Building _______ Equipment _______ Other _______
Existing Foundation:
Concrete _______ Block _______ Wood _______ Other_______
Basement _______Crawl Space _______ Footings _______ Slab ______ Blocking
______
New Foundation:
Concrete ________ Block ________ Wood _________ Other ________
Basement ______ Crawl Space _______ Footings ______ Slab ______ Blocking
______
Inside:
Plaster ________ Sheet Rock ________ Other_______
Outside:
Wood _______ Stucco _______ Steel ________ Vinyl ________ Asbestos ________
Brick ________ Other________
Fireplace:
Save ________ Size __________ Remove _______
Chimney: Save ________ Remove ________
Any Other Information or Notes:
