Municipal Data Collection Form

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Municipal Data Collection Form
Municipality: ______________________
Permit No. (if available):
Assessment ID No.: ______________________
 Construction/Renovation start date:
Assessment Roll Year: ______________________
 Construction/Renovation completion date:
Please provide as much information as possible. This will assist SAMA in providing accurate and timely valuations.
New Residential Construction 
No. of 
Plumbing 
Central Air 
Estimated  
Year Built Dimensions/ Floor area*(sqft) Bungalow Basement Wall Height
Fixtures
Heating Type
Conditioning
Fireplace 
Hot Tub
Construction Cost
New Home
Y or N
Y or N
Y or N
Y or N
Y or N
RTM
Y or N
Y or N
Y or N
Y or N
Y or N
MH
Y or N
Y or N
Y or N
Y or N
Summer Cottage
Y or N
Y or N
Y or N
Y or N
Y or N
Addition
Y or N
Y or N
Y or N
Y or N
Y or N
Deck
Y or N
Y or N
Y or N
Other ( shed/patio)
Y or N
Y or N
Y or N
Bsmt Development
Y or N
Y or N
Garage ‐ Attached
Garage ‐ Detached
* for complex residential buildings please provide copy of blueprints or drawings
Residential/Commercial Renovations: 
(Please circle all items that have been upgraded.)
Shingles      Siding      Windows      Doors      Furnace      Electrical      Plumbing      Fireplaces      Foundation      Interior Walls      Flooring
Comments:
New Commercial Construction
Use  (circle one)
OFFICE  /  RETAIL  /  WAREHOUSE
Use  (circle one)
OFFICE  /  RETAIL  /  WAREHOUSE
Year Built
Year Built
Area/Dimensions**
Area/Dimensions**
Frame Type
pole           wood           steel           conc block
Frame Type
pole           wood           steel           conc block
Wall Height
Wall Height
Exterior Siding 
metal          stucco          conc block          vinyl          other
Exterior Siding 
metal          stucco          conc block          vinyl          other
Insulated
Y or N
Insulated
Y or N
Heat Type
FHA        unit heater        radiant nat gas        other
Heat Type
FHA        unit heater        radiant nat gas        other
A/C
Wall Unit 
Central Air
Ventilation
A/C
Wall Unit
Central Air
Ventilation
Floor 
Y or N
Floor 
Y or N
  ** for complex commercial buildings please provide copy of blueprints or drawings
form last updated June 2009

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