SURVEY REQUIRED
DISCLAIMER:
DO NOT leave blanks anywhere in this document. If the City of Lynchburg receives this document with blanks it will be returned to the sender for correction.
Home/Property Owner: Make sure that you have been in contact with an Insurance Agent, and have their contact information, including email address to complete this form. If a survey is required, make contact with a Surveyor or Engineer and have their contact information, including email address to complete this form.
Surveyor/Engineer: Please print Page 2, apply seal and return to Erin Hawkins, Water Quality Manager, Water Resources, 525 Taylor Street, Lynchburg, VA 24501 immediately upon completion.
Section A
Completed by Home/Property Owner: Upon completion of this section, the home/property owner will then email it to their Insurance Agent of choice.
Section B
Completed by Insurance Agent: Upon completion of this section, the document will be forwarded to the home/property owner who will then email to their Surveyor of choice to complete Section C & D, along with uploading property photos on Pages 5 & 6.
Sections C & D
Completed by Surveyor or Engineer (if required): Upon completion of this section, the document will be forwarded to the home/property owner to complete Section E and F. Surveyor or Engineer will print out Page 2, apply seal and return hardcopy to Erin Hawkins, Water Quality Manager, Water Resources, 525 Taylor Street, Lynchburg, VA 24501 immediately upon completion.
Section E
N/A
Section F
Completed by Home/Property Owner.
Section G
Optional - Water Resources
Pages 5 & 6
Photos can be uploaded to this area by Home/Property Owner (if survey not required) or by Surveyor (if survey is required).
