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Last Name:
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Structure Type:
Single Family
2 - 4 Family
Condo
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Non-Residential
Year Built:
Estimated Replacement Cost:
Building Type:
1 Floor
2 Floor
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Attached Garage:
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One Car
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Three Car
Four Car
Foundation Type:
Cement Slab
Enclosed Crawl Space
Unfinished Basement
Piers/Piles/Posts
Solid Perimeter Walls
Personal Property Coverage Requested:
$0
$25,000
$50,000
$100,000
How Many Prior Flood Claims on this Property?
0
1
2
3+
Is the Property Currently in Escrow or being Refinanced?
Yes
No
Is the property within 1000 ft of water?
Yes
No
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