* 1. What is your street address in Town of Jerusalem?

* 2. How many people are named on your deed?

* 3. What type septic system do you currently have?

* 4. How old is you septic system?

* 5. Considering the cost of pumping holding tanks, annual or bi-annual inspections, or possible replacement costs of older systems, if Jerusalem were able to offer an extension of municipal sewer system with a cost in the range of $110 to $125 monthly, would you be in favor of a sewer system expansion?

* 6. If you would like to receive occasional informational updates about Jerusalem, please put your name and email below.

* 7. Questions, comments, suggestions, criticisms?