*** Housing Survey! ***
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City
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/50
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Street Address
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/50
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Do you rent or own?
Rent
Own
Homeless
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What type of home do you live in?
Mobile Home
Single Family Home (House)
Multi-Family Home (Apartment/Duplex)
Other
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/250
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What repairs are needed? Select all that apply
Roof
Bathroom
Floors
Ramp
Siding
Heating/Cooling
Doors
Windows
Plumbing
Walls
Other
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/250
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What is your annual household income?
$0 - $20,000
$20,000 - $40,000
$40,000 - $60,000
More than $60,000
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What's your household size?
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/50
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What can your community do to improve housing?
Better paying Jobs
Enforce Codes
More housing resources
Apply for more grants
Other
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/250
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Why haven't you repaired your home?
Can't afford it
Insurance problems/Delays
No one to do the work
Waiting on assistance
I do not own the house/ name not on the deed
My home does not need repairs
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Please list the streets or neighborhoods that need housing Improvements
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/250
If you have any additional comments please list them below
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/500
Submit Survey
