EML PHASE I REQUEST FORM

 

Name of Potential Client:                                                     _______________________________________

 

Address:                                                                                _______________________________________

 

                                                                                                _______________________________________

 

Client Contact:                                                                      _______________________________________

 

Telephone Number:                                                             (         )__________________________________

 

Fax Number:                                                                         (         )__________________________________

 

E-mail Address:                                                                    _______________________________________

 

Phase I Property Name:                                                       _______________________________________

 

__ Commercial      __ Industrial       __ Residential

 

Address of Property:                                                           _______________________________________

 

                                                                                                _______________________________________

 

Approximate Acreage:                                                        ___________________     __ acres   __ square feet

                               

Approximate Square Feet of Improvements:                  ________________________________________

 

Financing (if applicable):

 

 

 

Comments: _________________________________________________________________________               

 

__________________________________________________________________________________

 

__________________________________________________________________________________

 

__________________________________________________________________________________                                                      

 

(for EML use only)

 

Fee Proposed:                                                                       _________________________________________

               

Proposal Accepted:                                                              __ Yes                                      __ No

 

If No, Reason For Rejection:                                              _________________________________________

 

 

Report Sent:                                                                          Date: _________   How Mailed: _________

 

Invoice Sent:                                                                         Date: _________   Fee: _________