Contact Us

Name:

Street Address:

E-mail:

City, State, Zip:

Home Phone:

Work Phone:

New Home Information

Do You own/have a contract on the land?

Yes No

If so, Can you provide a land survey

Yes No

Project Address:

Block:

Lot Width:

Lot Length:

Lot:

Does the property have any of the following? (Check all that apply)

City water/sewer Septic/Well

Gas Electric

Demolition Needed? Yes No

Lot Cleared? Yes No

Pilings? Yes No

What style home are you interested in?

Cape Ranch 2 Story Multi Level

Contemporary Traditional

Colonial Victorian

Unknown

Other:

Approx. Sq. Ft.:

# Of Bedrooms:

# Of Baths:

Foundation Type: Crawl Space Full Basement Pilings

Heating System Forced Hot Air HWBB Natural Gas Oil

Central Air Conditioning: Yes No

Garage None 1-Car 2-Car 3+Car

How did you hear about
Modern Homes, Inc.?

How soon would you like to get started?
ASAP 1-3 months 3-6 months 6-9 months 9-12 months 1 year+