c411v-2014 Survey of Residential Attachment A

Attachment A

C-411(V)

FORM
(05-13-2014)

OMB No. 0607-0350: Approval Expires 10/31/2014
U.S. DEPARTMENT OF COMMERCE

SURVEY OF RESIDENTIAL
BUILDING OR ZONING PERMIT SYSTEMS

Economics and Statistics Administration

U.S. CENSUS BUREAU

Person Completing
This Survey
Name
Title
Telephone (Include area code)

Sample Form
Fax (Include area code)
E-mail address
Internet web address

This survey form is used to help us
identify permit-issuing jurisdictions
in the United States.
(Please correct any errors in name, address, and ZIP Code)

Mail or Fax to:
U.S. Census Bureau
Manufacturing and Construction Division
Residential Construction Branch
Washington, DC 20233–6900
(Fax) 1–301–763–8587

We would appreciate your response within 30 days
For further information call 1–800–845–8244

The following narrative describes our record of the latest information on your jurisdiction's geographic coverage:

Is this information correct?
Yes – Please return this form now.

No – Please explain in comments below.
Comments

If more space is needed, please attach a separate sheet.