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Basement Waterproofing
& Foundation Repair

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Home Estimates & Assessments

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Home Assessment Application

Basement Technologies®
Home Assessment Form:

Get your free home estimate for: basement waterproofing, foundation repairs, crack injections, and drain repairs. All information collected here will be held with strict confidentiality. Please read our privacy policy for details.

Personal Info

PERSONAL INFO
Your Contact Info:

ALL fields marked with (*) ARE required.

Prefix:
First Name:
Last Name:
Email:
Home Phone:
Cell Phone:
Best Contact Time?

Company:
Work Phone & Ext.:
Fax Number:

*
*
*
*
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Residential Project Icon RESIDENTIAL PROPERTY (#1):
(Project Information)

Please fill out the below form-fields as best as you can. The better the details, the easier it will be later on to cater a home assessment for your unique project needs.

ALL fields marked with (*) ARE required.

Property Info:

Ownership Info:***
Foundation Type:*
Finished Basement?
Year Constructed?

Full Address:*
Suite #:*
City:*
Postal Code:*
Cross Street(s):
Tenants Name:
Tenants Phone:

*
*



*
*
*
*



Service(s) Needed:

Project Information:

Misc Details:

• Has a permit been issued?
• Architectural drawings already created?

• Have you been pre-approved for gov. subsidy?
 » If so, which one?






ADD ANOTHER RESIDENTIAL PROPERTY (#2)

Residential Project Icon RESIDENTIAL PROPERTY (#2):
(Project Information)

Please let us know about any other property that require our services.

ALL fields marked with (*) ARE required.

Property Info:

Ownership Info:***
Foundation Type:*
Finished Basement?
Year Constructed?

Full Address:*
Suite #:*
City:*
Postal Code:*
Cross Street(s):
Tenants Name:
Tenants Phone:

*
*



*
*
*
*



Service(s) Needed:

WATERPROOFING:
Exterior Waterproofing
Interior Waterproofing
Window Well Installation
Sump Pump Installation
Crack Injections

FOUNDATION REPAIR:
Foundation Repair
Basement Lowering
Bowed Wall Repair
Foundation Piering
Floor Slab Replacement

DRAIN REPAIR:
Drain Repair
Backwater Valve Installation
Drain Replacement
Water Main Installation
Sewage Backup

Project Information:

Misc Details:

• Has a permit been issued?
• Architectural drawings already created?

• Have you been pre-approved for gov. subsidy?
 » If so, which one?






ADD ANOTHER RESIDENTIAL PROPERTY (#3)

Residential Project Icon RESIDENTIAL PROPERTY (#3):
(Project Information)

Please let us know about any other property that require our services.

ALL fields marked with (*) ARE required.

Property Info:

Ownership Info:***
Foundation Type:*
Finished Basement?
Year Constructed?

Full Address:*
Suite #:*
City:*
Postal Code:*
Cross Street(s):
Tenants Name:
Tenants Phone:

*
*



*
*
*
*



Service(s) Needed:

WATERPROOFING:
Exterior Waterproofing
Interior Waterproofing
Window Well Installation
Sump Pump Installation
Crack Injections

FOUNDATION REPAIR:
Foundation Repair
Basement Lowering
Bowed Wall Repair
Foundation Piering
Floor Slab Replacement

DRAIN REPAIR:
Drain Repair
Backwater Valve Installation
Drain Replacement
Water Main Installation
Sewage Backup

Project Information:

Misc Details:

• Has a permit been issued?
• architectural drawings already created?

• Have you been pre-approved for gov. subsidy?
 » If so, which one?






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RESIDENTIAL LAYOUT (SAMPLE):

Click on the illustration to see a typical residential layout sample showcasing the perimeter obstacles.

Residential Home Layout Illustration