Facility Planning Survey

This is our Facility Planning Survey. We invite you to fill out the items below to the best of your ability so we can serve you better with your next build or expansion.

After you fill out this form, a Roth representative will contact you to talk about your project.

Facility Use Choose one ------------------- Airport structure Automobile dealership Commercial Education Industrial Food processing Manufacturing Religious Transportation Warehouse/Distribution Other

Square Feet sqft.

Budget

Do you need to build a new facility or expand your present facility? New Facility Expand/Renovate

Do you own the land? Yes No

Is there enough space on the land for future growth? Yes No

Will additional land need to be acquired? Yes No

Is the land zoned properly for the intended use of the property? Yes No Don't know

Are special variances required to use the property as intended? (i.e., building height or size restrictions, building use restrictions) Yes No Don't know

Are there special ordinances dictating the exterior appearance of the building? (i.e., brick, architectural block, wall panels, signage) Yes No Don't know

Are there wetlands, woodlands, lakes, or streams present on or adjacent to the property? Yes No

Is special DNR approval required? Yes No

Is the property accessible to major highways and railways? Yes No

Are site utilities available to the property? (i.e., electric, gas, water, sanitary sewer, storm sewer) Yes No Don't know

Is a rail siding required? Yes No

Can the rail siding easily be accessible to the building? Yes No N/A

Are there special site requirements relating to vehicle access or shipping and receiving traffic? Yes No Have not considered

Are there special requirements for parking? (i.e., on-site car, truck or trailer storage requirements, employee and customer parking requirements) Yes No Have not considered

Do you have a legal description, survey and topography of the property? Yes No

Do you have a geotechnical survey and report (soil borings)? Yes No

Do you have a Phase I Environmental Survey of the property? Yes No

Will a Phase II Environmental Survey be required? Yes No Not sure

How is the project being financed?
Mortgage
Insurance company
Industrial revenue bonds
Other (If other, please explain)

Have you compiled the basic size, layout and general building requirements for your new facility or expansion? Yes No

Have you contracted the services of an architectural and engineering firm to assist you in the planning and design of your new facility or expansion? Yes No

Please use this space for any additional comments and questions