Request for New Construction Termite Pre-treatment

Date:

Bill to:

•                 Contractor Name/Company

•                 Billing Address

•                 Billing City           State           Zip Code

•                 Contact Person    Phone#

Property to be serviced:    

•                 Property Address

•                                                 (You must provide a street address)

•                 Lot#/Neighborhood

•                                                 (if known)

•                 City   State     Zip Code

• Type of Construction:    Slab Basement CrawlSpace Combo: Crawl & basement       

• Is there an attached garage? No Yes

• Approximate pour date of any/all cement slabs. 

Reminder: You must call before any cement slabs are poured.

• Approximate square footage of the first floor of thestructure including porches, garages, and any other external structures you would like treated:

• Current stage of Construction: Foundation Framing Nearly Complete

Additional information need for HUD Pre-treatments

• Is this a HUD loan pretreatment: No Yes (If No, then skip this section.)

• Approximate Depth of footing:Outside foundation wallInside foundation wall

• Type of back fill: (IE: soil, soil/gravel, etc)

• Linear foot of the structure:

• Linear foot of masonry voids:

        *** Masonry voids are any foundation walls of the structure that are built with 8" block, 8" block and brick,  and/or  4" block & brick veneer combo.  Single layer brick wall and stone foundation walls do not apply.

  After submitting, please print out confirmation page for you records.